rs137853010
Variant summary
Our verdict is Likely benign. The variant received -3 ACMG points: 0P and 3B. BP4_ModerateBS2_Supporting
The NM_007194.4(CHEK2):c.541C>T(p.Arg181Cys) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000806 in 1,613,650 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 13/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R181H) has been classified as Likely benign.
Frequency
Consequence
NM_007194.4 missense
Scores
Clinical Significance
Conservation
Publications
- CHEK2-related cancer predispositionInheritance: AD Classification: DEFINITIVE Submitted by: Ambry Genetics
- hereditary breast carcinomaInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), ClinGen
- Li-Fraumeni syndrome 2Inheritance: AD Classification: DEFINITIVE Submitted by: G2P
- acute myeloid leukemiaInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- hereditary nonpolyposis colon cancerInheritance: AD Classification: LIMITED Submitted by: ClinGen
- familial ovarian cancerInheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
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ACMG classification
Our verdict: Likely_benign. The variant received -3 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| CHEK2 | NM_007194.4 | c.541C>T | p.Arg181Cys | missense_variant | Exon 4 of 15 | ENST00000404276.6 | NP_009125.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| CHEK2 | ENST00000404276.6 | c.541C>T | p.Arg181Cys | missense_variant | Exon 4 of 15 | 1 | NM_007194.4 | ENSP00000385747.1 |
Frequencies
GnomAD3 genomes AF: 0.0000593 AC: 9AN: 151874Hom.: 0 Cov.: 32 show subpopulations
GnomAD2 exomes AF: 0.000111 AC: 28AN: 251404 AF XY: 0.000132 show subpopulations
GnomAD4 exome AF: 0.0000828 AC: 121AN: 1461776Hom.: 0 Cov.: 32 AF XY: 0.000107 AC XY: 78AN XY: 727188 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000593 AC: 9AN: 151874Hom.: 0 Cov.: 32 AF XY: 0.0000809 AC XY: 6AN XY: 74146 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
Familial cancer of breast Uncertain:9
This variant is classified as a variant of uncertain significance as there is insufficient evidence to determine its impact on protein function and/or cancer risk. -
This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 181 of the CHEK2 protein (p.Arg181Cys). This variant is present in population databases (rs137853010, gnomAD 0.05%), and has an allele count higher than expected for a pathogenic variant. This missense change has been observed in individual(s) with CHEK2-related conditions (PMID: 18058223, 18996005, 22419737, 29522266, 36468172). ClinVar contains an entry for this variant (Variation ID: 5597). An algorithm developed to predict the effect of missense changes on protein structure and function outputs the following: PolyPhen-2: "Benign". The cysteine amino acid residue is found in multiple mammalian species, which suggests that this missense change does not adversely affect protein function. Experimental studies are conflicting or provide insufficient evidence to determine the effect of this variant on CHEK2 function (PMID: 16835864, 22419737, 30851065). 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. -
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a variant of uncertain significance was detected in the CHEK2 gene (c.541C>T). This sequence change replaces arginine, which is basic and polar, with cysteine, which is neutral and slightly polar, at codon 181 of the CHEK2 protein (p.Arg181Cys).This amino acid position is poorly conserved(PhyloP=2.3). This variant is present in population databases (rs137853010, gnomAD 0.05%), and has an allele count higher than expected for a pathogenic variant. This missense change has been observed in individual(s) with breast, ovarian and colorectal cancer (PMID: 18058223, 18996005, 22419737, 29522266). ClinVar contains an entry for this variant (Variation ID: 5597). In addition, this alteration is predicted to be tolerated by in silico analysis. 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. -
Criteria applied: PM5 -
This submission and the accompanying classification are no longer maintained by the submitter. For more information on current observations and classification, please contact variantquestions@myriad.com. -
not provided Uncertain:6
The CHEK2 c.541C>T (p.Arg181Cys) variant has been reported in the published literature in individuals affected with breast cancer (PMID: 34711244 (2021), 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared)), 32923877 (2020), 29522266 (2018), 28779002 (2017), 22419737 (2012), 18058223 (2008)), prostate cancer (PMID: 29520813 (2018), 16835864 (2006)), colon/rectal cancer (PMID: 34711244 (2021), 18996005 (2009)), and pediatric B-cell acute lymphoblastic leukemia (B-ALL) (PMID: 36468172 (2023)). This variant has also been observed in reportedly healthy individuals (PMID: 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared)), 31050813 (2019), 30287823 (2018)). Assessment of experimental evidence regarding the effect of this variant on protein function is inconclusive (PMID: 36468172 (2023), 31050813 (2019), 30851065 (2019), 22419737 (2012), 16835864 (2006)). The frequency of this variant in the general population, 0.00052 (16/30612 chromosomes (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is uninformative in the assessment of its pathogenicity. Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded conflicting predictions that this variant is deleterious or benign. Based on the available information, we are unable to determine the clinical significance of this variant. -
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In silico analysis indicates that this missense variant does not alter protein structure/function; Not observed at significant frequency in large population cohorts (gnomAD); Also known as c.670C>T p.(R224C); Published functional studies are conflicting: some show reduced response to DNA damage and kinase activity, while others show kinase activity and DNA damage response comparable to wild-type (PMID: 16835864, 22419737, 30851065, 31050813, 37449874); Observed in individuals with CHEK2-related cancers, but also in unaffected controls (PMID: 12533788, 16835864, 16941491, 18058223, 18996005, 28779002, 29522266, 30287823, 29520813, 32923877, 33471991, 34711244, 36243179, 33309985, 32980694, 37449874); This variant is associated with the following publications: (PMID: 26822949, 16835864, 27157322, 12533788, 22419737, 18058223, 16941491, 18996005, 19782031, 21765476, 29520813, 28873162, 30851065, 31050813, 30287823, 34711244, 34426522, 36468172, 28125078, 28779002, 26580448, 29522266, 32923877, 33471991, 32980694, 36243179, 33309985, 32906206, 38630906, 37449874) -
not specified Uncertain:3
Variant summary: CHEK2 c.541C>T (p.Arg181Cys) results in a non-conservative amino acid change located in the Forkhead-associated (FHA) domain (IPR000253) of the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.00011 in 251404 control chromosomes, predominantly at a frequency of 0.00052 within the South Asian subpopulation in the gnomAD database. The observed variant frequency within South Asian control individuals in the gnomAD database is approximately 1.7 fold of the estimated maximal expected allele frequency for a pathogenic variant in CHEK2 causing Hereditary Breast and Ovarian Cancer phenotype (0.00031), suggesting that the variant might be a benign polymorphism. c.541C>T has been reported in the literature in individuals affected with prostate-, breast- and colorectal cancer, as well as in pediatric acute lymphoblastic leukemia and Ewing sarcoma, and multiple primary tumors (Dong_2003, Wu_2018, Kleibl_2008, Kleibl_2009, Zhang_2016, Brohl_2017, Dorling_2021, Wallander_2021), however it was also reported in several unaffected controls (Momozawa_2018, Kleiblova_2019, Narang_2020, Dorling_2021, Mizukami_2020). These reports therefore do not provide unequivocal conclusions about association of the variant with the disease. Several publications reported experimental evidence evaluating an impact on protein function, and demonstrated for the variant protein unaffected autophosphorylation, but partially reduced kinase activity in a mammalian cell system (Wu_2006), as well as an intermediate response to DNA damage in a yeast complementation assay (Roeb_2012). However later studies reported the variant to be similar to WT in a yeast complementation assay (Delimitsou_2019) and with unaffected kinase activity in mammalian cells (Kleiblova_2019). Nine other clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014, and all of them classified the variant as uncertain significance. Based on the evidence outlined above, the variant was classified as VUS-possibly benign. -
DNA sequence analysis of the CHEK2 gene demonstrated a sequence change, c.541C>T, in exon 4 that results in an amino acid change, p.Arg181Cys. This sequence change has been previously described in one individual with prostate cancer (PMID: 29520813) and has been described in the gnomAD database with a frequency of 0.011% in the overall population (dbSNP rs137853010). The p.Arg181Cys change affects a poorly conserved amino acid residue located in a domain of the CHEK2 protein that is known to be functional. In-silico pathogenicity prediction tools (SIFT, PolyPhen2, Align GVGD, REVEL) provide contradictory results for the p.Arg181Cys substitution. Due to insufficient evidences and the lack of functional studies, the clinical significance of the p.Arg181Cys change remains unknown at this time. -
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Hereditary cancer-predisposing syndrome Uncertain:3
This missense variant replaces arginine with cysteine at codon 181 of the CHEK2 protein. Computational prediction suggests that this variant may not impact protein structure and function. Functional studies have shown conflicting results, showing the mutant protein to be functional in in vitro kinase and DNA damage response assays (PMID: 16835864, 30851065, 31050813, 36468172, 37449874), but also exhibit partially reduced activity (PMID: 22419737), or no activity (PMID: 36468172) in similar assays. This variant has been reported in individuals affected with breast cancer (PMID: 18058223, 22419737, 29522266, 34711244), colorectal cancer (PMID: 18996005, 34711244), prostate cancer (PMID: 12533788, 16835864, 29520813), and other hereditary cancers (PMID: 26580448, 28873162, 36468172). This variant did not show a significant association with breast cancer in two case control studies (PMID: 33471991, OR=1.768, 95%CI 0.442 to 7.07; PMID: 37449874, OR 1.70 (0.77-3.86). This variant has been identified in 31/282774 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. -
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The p.R181C variant (also known as c.541C>T), located in coding exon 3 of the CHEK2 gene, results from a C to T substitution at nucleotide position 541. The arginine at codon 181 is replaced by cysteine, an amino acid with highly dissimilar properties. This alteration has been reported in individuals diagnosed with breast cancer, colorectal cancer, and/or prostate cancer (Zheng L et al. Hum. Mutat. 2006 Oct;27:1062-3; Wu Y et al. Prostate. 2018 Jun;78:607-615; Kleibl Z et al. Breast Cancer Res. Treat. 2008 Nov;112:159-64; Hauke J et al. Cancer Med. 2018 Apr;7:1349-1358; Kleibl Z et al. Eur. J. Cancer. 2009 Mar;45:618-24). Several yeast-based functional studies have reported this variant to result in a partial reduction in activity (Wu X et al. Hum. Mutat. 2006 Aug;27:742-7; Roeb W et al. Hum. Mol. Genet. 2012 Jun;21:2738-44), while other functional studies conducted in yeast and human cell lines have reported this variant to have a neutral impact on CHEK2 activity (Delimitsou A et al. Hum Mutat. 2019 May;40(5):631-648; Kleiblova P et al. Int J Cancer. 2019 Oct;145(7):1782-1797; Stolarova L et al. Clin Cancer Res. 2023 Aug;29(16):3037-3050). This amino acid position is poorly conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Based on the available evidence, the clinical significance of this variant remains unclear. -
Prostate cancer, somatic Pathogenic:1
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CHEK2-related disorder Uncertain:1
The CHEK2 c.541C>T variant is predicted to result in the amino acid substitution p.Arg181Cys. This variant has been reported in individuals with a history of colorectal, breast, or prostate cancers and was absent from control cohorts (Dong et al. 2003. PubMed ID: 12533788; Wu et al. 2006. PubMed ID: 16835864; Kleibl et al. 2008. PubMed ID: 18058223; Kleibl et al. 2009. PubMed ID: 18996005; Wu et al. 2018. PubMed ID: 29520813). Functional assays have demonstrated that this variant impacts CHEK2 kinase activity and has an intermediate response to DNA damage (Roeb et al. 2012. PubMed ID: 22419737; Wu et al. 2006. PubMed ID: 16835864). Results of an in vivo, yeast‐based, functional assay indicated that this variant did not impact growth, which suggests this allele may be functional (i.e. benign) (Delimitsou et al. 2019. PubMed ID: 30851065). This variant is reported in 0.052% of alleles in individuals of South Asian descent in gnomAD and is interpreted as uncertain significance in ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/variation/5597/). At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -
Predisposition to cancer Uncertain:1
The CHEK2 c.541C>T p.(Arg181Cys) missense change has a maximum subpopulation frequency of 0.05% in gnomAD v2.1.1 (https://gnomad.broadinstitute.org). The in silico tool REVEL is inconclusive about a pathogenic or benign effect of this variant on protein function and functional studies are conflicting (PMID: 16835864, 22419737, 30851065, 31050813). This variant has been reported in individuals with prostate cancer, breast cancer, and colorectal cancer (PMID: 12533788, 16835864, 18058223, 18996005, 22419737, 29522266, 34711244). In summary, the evidence currently available is insufficient to determine the clinical significance of this variant. It has therefore been classified as of uncertain significance. -
CHEK2-related cancer predisposition Uncertain:1
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Hereditary breast ovarian cancer syndrome Benign:1
According to the ACMG SVI adaptation criteria we chose these criteria: BS1 (supporting benign): gnomAD v2 (non-cancer) South Asian 0,05%, BS3 (strong benign): Storalova (PMID: 37449874) & Delimitsou (PMID: 30851065) benign -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at