2-47470993-A-G
Variant summary
Our verdict is Benign. Variant got -12 ACMG points: 0P and 12B. BP4_StrongBP6_Very_Strong
The NM_000251.3(MSH2):c.1690A>G(p.Thr564Ala) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000588 in 1,564,040 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 14/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Benign (★★★).
Frequency
Consequence
NM_000251.3 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Benign. Variant got -12 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000985 AC: 15AN: 152218Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.000232 AC: 58AN: 250388Hom.: 0 AF XY: 0.000199 AC XY: 27AN XY: 135348
GnomAD4 exome AF: 0.0000545 AC: 77AN: 1411704Hom.: 0 Cov.: 25 AF XY: 0.0000496 AC XY: 35AN XY: 705514
GnomAD4 genome AF: 0.0000985 AC: 15AN: 152336Hom.: 0 Cov.: 32 AF XY: 0.0000805 AC XY: 6AN XY: 74490
ClinVar
Submissions by phenotype
Lynch syndrome 1 Uncertain:1Benign:2
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This variant is considered benign. This variant is strongly associated with less severe personal and family histories of cancer, typical for individuals without pathogenic variants in this gene [PMID: 27363726]. This variant has been observed in conjunction with multiple pathogenic variants, reducing the likelihood this variant itself is pathogenic. -
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not provided Benign:3
Variant summary: The MSH2 c.1690A>G (p.Thr564Ala) variant involves the alteration of a conserved nucleotide. 2/3 in silico tools predict a benign outcome for this variant (SNPs&GO and Mutation Taster not captured due to low reliability index). This variant was found in 22/120830 control chromosomes, predominantly observed in the East Asian subpopulation at a frequency of 0.002547 (22/8638). This frequency is about 4 times the estimated maximal expected allele frequency of a pathogenic MSH2 variant (0.0005683), suggesting this is likely a benign polymorphism found primarily in the populations of East Asian origin. The variant was found in several studies assessing colorectal cancer patients with normal IHC and microsatellite stable tumors; however no strong evidence for pathogenicity were present. Furthermore, in one family the variant did not co-segregate with the disease, and the cause of cancer in this family was attributed to a pathogenic variant in the APC gene, further supporting a neutral outcome. In addition, multiple clinical diagnostic laboratories/reputable databases classified this variant as benign/likely benign. Considering all evidence, the variant is classified as Benign. -
This variant is associated with the following publications: (PMID: 22290698, 15996210, 24362816, 12200596, 18726168, 24735542, 17192056, 25980754, 24710284, 26900293, 29506494) -
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Hereditary cancer-predisposing syndrome Benign:3
This alteration is classified as likely benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -
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not specified Benign:2
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Variant identified in a genome or exome case(s) and assessed due to predicted null impact of the variant or pathogenic assertions in the literature or databases. Disclaimer: This variant has not undergone full assessment. The following are preliminary notes: This variant has been seen in 0.25% of East Asian chrs (0.31% in gnomAD - too high for disease frequency). It is classified in ClinVar with 3 stars as benign by an expert panel (InSiGHT) and Invitae. It has been reported in 3 papers: in one it did not segregate in the family with disease, in one it was predicted to be not pathogenic, and one where MSH2 expression was retained. Rabbit also has an Alanine at this position. -
Breast and/or ovarian cancer Benign:1
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MSH2-related disorder Benign:1
This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -
Carcinoma of colon Benign:1
The MSH2 p.Thr564Ala variant was identified in 8 of 468 proband chromosomes (frequency: 0.02) from Chinese and Taiwanese individuals or families with HNPCC/suspected HNPCC related CRC (Chang_2016_26900293, Lee_2005_15996210, Yap_2009_18726168). In a 4 generation Han Chinese family affected with polyposis, sequencing of 5 genes related to HNPCC/FAP found the variant to co-occur with a truncating APC variant (c.694C>), and the variant was found in both affected and unaffected members (Zhang_2014_24735542). Two bioinformatics prediction models pathogenic-or-not mismatch repair (PONMMR), and multivariate analysis of protein polymorphisms–mismatch repair (MAPP-MMR) assessed the variant as neutral (Ali_2012_22290698, Chao_2008_18383312). The variant was also identified in dbSNP (ID: rs55778204) “With Likely benign allele”, ClinVar (classified benign, reviewed by an expert panel (2013); submitters: benign by InSIGHT, and likely benign by Invitae, GeneDx, Laboratory for Molecular Medicine (Partners HealthCare Personalized Medicine), and Quest Diagnostics Nichols Institute San Juan Capistrano), Clinvitae (2x), Insight Colon Cancer Gene Variant Database (13x as class 1), Zhejiang Colon Cancer Database (2x), Mismatch Repair Genes Variant Database, Insight Hereditary Tumors Database (14x), and was not identified in GeneInsight-COGR, Cosmic, MutDB, or UMD-LSDB. The variant was identified in control databases in 59 of 276412 chromosomes at a frequency of 0.0002 increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database Feb 27, 2017). Breakdown of the observations by population include East Asian in 59 of 18860 chromosomes (freq: 0.003), while not observed in the African, Other, Latino, European Non-Finnish, Ashkenazi Jewish, European Finnish, and South Asian populations. The p.Thr564 residue is not conserved in mammals and four out of five computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of the variant Ala impacting the protein; however, this information is not predictive enough to rule out pathogenicity. The variant occurs outside of the splicing consensus sequence and 2 of 5 in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer, HumanSpliceFinder) predict a greater than 10% difference in splicing; this is not very predictive of pathogenicity. In summary, based on the above information this variant meets our laboratory's criteria to be classified as benign. -
Lynch syndrome Benign:1
Multifactorial likelihood analysis posterior probability <0.001 -
Hereditary nonpolyposis colorectal neoplasms Benign:1
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Muir-Torré syndrome;C2936783:Lynch syndrome 1;C5436806:Mismatch repair cancer syndrome 2 Benign:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at