Our verdict is Uncertain significance. Variant got 2 ACMG points: 2P and 0B. PM5
The ENST00000265849.12(PMS2):c.452G>A(p.Arg151His) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.00000931 in 1,611,512 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R151G) has been classified as Uncertain significance.
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]
Verdict is Uncertain_significance. Variant got 2 ACMG points.
PM5
Other missense variant is known to change same aminoacid residue: Variant chr7-6002538-C-TG is described in ClinVar as [Pathogenic]. Clinvar id is 1741265.Status of the report is criteria_provided_single_submitter, 1 stars.
Uncertain significance, criteria provided, single submitter
clinical testing
Ambry Genetics
Jun 13, 2023
The p.R151H variant (also known as c.452G>A), located in coding exon 5 of the PMS2 gene, results from a G to A substitution at nucleotide position 452. The arginine at codon 151 is replaced by histidine, an amino acid with highly similar properties. This alteration has been detected in 1/937 unselected Chinese breast cancer patients and in 10/26 Chinese patients who met at least Bethesda guidelines for Lynch syndrome (Sheng X et al. World J. Gastroenterol. 2010 Aug;16(30):3847-52; Li JY et al. Int J Cancer. 2019 Jan 15;144(2):281-289). This alteration was identified in a cohort of Chinese breast cancer patients (Chen B et al. Aging (Albany NY), 2020 Feb;12:3140-3155). This amino acid position is highly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Uncertain significance, criteria provided, single submitter
clinical testing
Color Diagnostics, LLC DBA Color Health
Mar 16, 2023
This missense variant replaces arginine with histidine at codon 151 of the PMS2 protein. Computational prediction is inconclusive regarding the impact of this variant on protein structure and function (internally defined REVEL score threshold 0.5 < inconclusive < 0.7, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in 10 of 26 Chinese individuals affected with Lynch syndrome (PMID: 20698049) and in a Chinese breast/ovarian cancer case (PMID: 32068069). This variant has been identified in 3/250806 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
not specified Uncertain:1
Uncertain significance, criteria provided, single submitter
clinical testing
Quest Diagnostics Nichols Institute San Juan Capistrano
Feb 23, 2017
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Lynch syndrome 1 Uncertain:1
Uncertain significance, no assertion criteria provided
clinical testing
Pathway Genomics
Jul 24, 2014
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Lynch syndrome Uncertain:1
Uncertain significance, criteria provided, single submitter
clinical testing
All of Us Research Program, National Institutes of Health
Jul 10, 2023
This missense variant replaces arginine with histidine at codon 151 of the PMS2 protein. Computational prediction is inconclusive regarding the impact of this variant on protein structure and function (internally defined REVEL score threshold 0.5 < inconclusive < 0.7, PMID: 27666373). Splice site prediction tools suggest that this variant may not impact RNA splicing. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in 10 of 26 Chinese individuals affected with Lynch syndrome (PMID: 20698049) and in a Chinese breast/ovarian cancer case (PMID: 32068069) suggesting that this variant may be a common polymorphism in that population. This variant has been identified in 3/250806 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
not provided Uncertain:1
Uncertain significance, criteria provided, single submitter
clinical testing
GeneDx
Dec 09, 2023
In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 21153778, 19389263, 31857677, 29752822, 20698049, 35449176, 11574484, 32091409) -
Uncertain significance, criteria provided, single submitter
clinical testing
Labcorp Genetics (formerly Invitae), Labcorp
Jan 29, 2024
This sequence change replaces arginine, which is basic and polar, with histidine, which is basic and polar, at codon 151 of the PMS2 protein (p.Arg151His). This variant is present in population databases (rs35629870, gnomAD 0.006%). This missense change has been observed in individual(s) with Lynch syndrome and breast cancer (PMID: 20698049, 29752822, 35449176). ClinVar contains an entry for this variant (Variation ID: 156510). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is expected to disrupt PMS2 protein function with a positive predictive value of 80%. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Lynch syndrome 4 Uncertain:1
Uncertain significance, criteria provided, single submitter