Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000535.7(PMS2):c.1204C>T(p.Gln402*) variant causes a stop gained change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000000684 in 1,461,084 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. Q402Q) has been classified as Likely benign. Variant results in nonsense mediated mRNA decay.
PMS2 (HGNC:9122): (PMS1 homolog 2, mismatch repair system component) The protein encoded by this gene is a key component of the mismatch repair system that functions to correct DNA mismatches and small insertions and deletions that can occur during DNA replication and homologous recombination. This protein forms heterodimers with the gene product of the mutL homolog 1 (MLH1) gene to form the MutL-alpha heterodimer. The MutL-alpha heterodimer possesses an endonucleolytic activity that is activated following recognition of mismatches and insertion/deletion loops by the MutS-alpha and MutS-beta heterodimers, and is necessary for removal of the mismatched DNA. There is a DQHA(X)2E(X)4E motif found at the C-terminus of the protein encoded by this gene that forms part of the active site of the nuclease. Mutations in this gene have been associated with hereditary nonpolyposis colorectal cancer (HNPCC; also known as Lynch syndrome) and Turcot syndrome. [provided by RefSeq, Apr 2016]
PMS2 Gene-Disease associations (from GenCC):
Lynch syndrome
Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
Lynch syndrome 4
Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae), Genomics England PanelApp
mismatch repair cancer syndrome 1
Inheritance: AR Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
Our verdict: Pathogenic. The variant received 18 ACMG points.
PVS1
Loss of function variant, product undergoes nonsense mediated mRNA decay. LoF is a known mechanism of disease.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 7-5987561-G-A is Pathogenic according to our data. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr7-5987561-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 1748379.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing
The p.Gln402X variant in PMS2 has not been reported in individuals with PMS2-associated cancers or in large population studies. This nonsense variant leads to a premature termination codon at position 402, which is predicted to lead to a truncated or absent protein. Loss of function of the PMS2 gene is an established disease mechanism in autosomal dominant Lynch syndrome. In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal dominant Lynch syndrome. ACMG/AMP Criteria applied: PVS1, PM2_Supporting. -
This sequence change creates a premature translational stop signal (p.Gln402*) in the PMS2 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in PMS2 are known to be pathogenic (PMID: 21376568, 24362816). This variant is not present in population databases (gnomAD no frequency). This variant has not been reported in the literature in individuals affected with PMS2-related conditions. ClinVar contains an entry for this variant (Variation ID: 1748379). For these reasons, this variant has been classified as Pathogenic. -
The p.Q402* pathogenic mutation (also known as c.1204C>T), located in coding exon 11 of the PMS2 gene, results from a C to T substitution at nucleotide position 1204. This changes the amino acid from a glutamine to a stop codon within coding exon 11. This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -
Lynch syndrome 4Pathogenic:1
Sep 20, 2023
Myriad Genetics, Inc.
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing
This variant is considered pathogenic. This variant creates a termination codon and is predicted to result in premature protein truncation. -