rs267608077
Variant summary
Our verdict is Pathogenic. Variant got 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000179.3(MSH6):c.1135_1139delAGAGA(p.Arg379fs) variant causes a frameshift change. The variant allele was found at a frequency of 0.00000274 in 1,461,882 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Pathogenic (★★★). Variant results in nonsense mediated mRNA decay.
Frequency
Consequence
NM_000179.3 frameshift
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 18 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD3 exomes AF: 0.00000398 AC: 1AN: 250986Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 135632
GnomAD4 exome AF: 0.00000274 AC: 4AN: 1461882Hom.: 0 AF XY: 0.00 AC XY: 0AN XY: 727244
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
not provided Pathogenic:6Uncertain:1
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This nonsense variant causes the premature termination of MSH6 protein synthesis. In the published literature, it has been reported in individuals affected with endometrial, ovarian, and breast cancer (PMID: 17117178 (2006), 17453009 (2007), 25617771 (2015), 26681312 (2015)), as well as in a compound heterozygous individual with CMMRD syndrome (PMID: 30013564 (2018)). Based on the available information, this variant is classified as pathogenic. -
Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss-of-function is a known mechanism of disease; Observed in individuals with a personal or family history consistent with pathogenic variants in this gene (Kets et al., 2006; Frolova et al., 2015); Not observed at a significant frequency in large population cohorts (gnomAD); Truncating variants in this gene are considered pathogenic by a well-established clinical consortium and/or database; This variant is associated with the following publications: (PMID: 28888541, 17117178, 17453009, 25617771, 26681312, 26845104, 27064304, 28152038, 28452373, 26689913, 28514183, 29625052, 30787465, 30013564) -
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Lynch syndrome 5 Pathogenic:4
Criteria applied: PVS1,PM2_SUP,PM3_SUP,PP4 -
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This variant is considered pathogenic. This variant creates a termination codon and is predicted to result in premature protein truncation. -
ACMG criteria used to clasify this variant: PVS1, PM2 -
Lynch syndrome Pathogenic:4
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Coding sequence variation resulting in a stop codon -
The c.1135_1139del (p.Arg379*) variant in the MSH6 gene, that encodes for mutS homolog 6, introduces a premature translation termination codon resulting in an absent or disrupted protein product. The variant has been reported in several individuals (>10) affected with endometrial, ovarian, breast, colorectal cancers and Lynch syndrome (PMID:17117178, 17453009, 25617771, 28452373, 28514183, 26681312). Loss-of-function variants in MSH6 are known to be pathogenic (PMID: 9354786, 11709755, 20028993, 25318681). Truncating variants downstream of this variant are reported to be pathogenic in the literature (PMID: 29345684, 28514183) and by several ClinVar submitters (ClinVar ID: 418928, 1172098, 183736, 89184). This variant is found to be rare (1/250986; 0.000003984) in the general population database, gnomAD and interpreted as pathogenic by several ClinVar submitters including the expert panel (ClinVar ID: 89174). Therefore, the c.1135_1139del (p.Arg379*) variant in the MSH6 gene is classified as pathogenic. -
The c.1135_1139del (p.Arg379*) variant in the MSH6 gene, that encodes for mutS homolog 6, introduces a premature translation termination codon resulting in an absent or disrupted protein product. The variant has been reported in several individuals (>10) affected with endometrial, ovarian, breast, colorectal cancers and Lynch syndrome (PMID:17117178, 17453009, 25617771, 28452373, 28514183, 26681312). Loss-of-function variants in MSH6 are known to be pathogenic (PMID: 9354786, 11709755, 20028993, 25318681). Truncating variants downstream of this variant are reported to be pathogenic in the literature (PMID: 29345684, 28514183) and by several ClinVar submitters (ClinVar ID: 418928, 1172098, 183736, 89184). This variant is found to be rare (1/250986; 0.000003984) in the general population database, gnomAD and interpreted as pathogenic by several ClinVar submitters including the expert panel (ClinVar ID: 89174). Therefore, the c.1135_1139del (p.Arg379*) variant in the MSH6 gene is classified as pathogenic. -
Hereditary cancer-predisposing syndrome Pathogenic:2
The c.1135_1139delAGAGA pathogenic mutation (also known as p.R379*), located in coding exon 4 of the MSH6 gene, results from a deletion of 5 nucleotides at nucleotide positions 1135 to 1139. This changes the amino acid from an arginine to a stop codon within coding exon 4. This mutation has been previously identified in an individual diagnosed with Lynch syndrome (Kets CM et al. Br. J. Cancer. 2006 Dec 18;95(12): 1678-82) and in a patient with CMMRD (Tesch VK et al. Front Immunol. 2018 Jul;9:1506). It has also been reported in an individual with breast cancer at age 60, as well as endometrial and ovarian cancer at age 61, whose endometrial tumor showed loss of MSH2 on IHC (Frolova AI et al. Gynecol. Oncol. 2015 Apr;137:7-13). In addition to the clinical data presented in the literature, 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. -
This variant deletes 5 nucleotides in exon 4 of the MSH6 gene, creating a frameshift and premature translation stop signal. This variant is expected to result in an absent or non-functional protein product. This variant has been observed in individuals affected with colorectal cancer (PMID: 17117178), endometrial and/or ovarian cancer (PMID: 17453009, 26845104, 25617771), and cervical cancer (PMID: 26681312). This variant has been identified in 1/250986 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of MSH6 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. -
Hereditary nonpolyposis colon cancer Pathogenic:1
Variant summary: MSH6 c.1135_1139delAGAGA (p.Arg379X) results in a premature termination codon, predicted to cause absence of the protein due to nonsense mediated decay, which is a commonly known mechanism for disease. The variant allele was found at a frequency of 4e-06 in 250986 control chromosomes (gnomAD). c.1135_1139delAGAGA has been reported in the literature in individuals affected with Lynch Syndrome and Lynch Syndrome-associated malignancies (e.g. Kets_2006, Shirts_2015, Susswein_2015, Frolova_2017). These data indicate that the variant is very likely to be associated with disease. The following publications have been ascertained in the context of this evaluation (PMID: 17117178, 26681312, 25617771, 26845104). ClinVar contains an entry for this variant (Variation ID: 89174). Based on the evidence outlined above, the variant was classified as pathogenic. -
Lynch syndrome 1 Pathogenic:1
ACMG criteria used to clasify this variant: PVS1, PM2, PS4 -
Hereditary nonpolyposis colorectal neoplasms Pathogenic:1
This sequence change creates a premature translational stop signal (p.Arg379*) in the MSH6 gene. It is expected to result in an absent or disrupted protein product. Loss-of-function variants in MSH6 are known to be pathogenic (PMID: 18269114, 24362816). This variant is present in population databases (rs777907133, gnomAD 0.0009%). This premature translational stop signal has been observed in individual(s) with colorectal polyps, endometrial cancer, and cervical cancer (PMID: 17117178, 25617771, 26681312, 26845104, 28514183). Invitae Evidence Modeling of clinical and family history, age, sex, and reported ancestry of multiple individuals with this MSH6 variant has been performed. This variant is expected to be pathogenic with a positive predictive value of at least 99%. This is a validated machine learning model that incorporates the clinical features of 1,370,736 individuals referred to our laboratory for MSH6 testing. For these reasons, this variant has been classified as Pathogenic. -
Endometrial carcinoma Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at