rs587780046
Variant summary
Our verdict is Benign. Variant got -7 ACMG points: 0P and 7B. BP4_ModerateBP6BS1
The NM_000535.7(PMS2):c.2012C>T(p.Thr671Met) variant causes a missense change. The variant allele was found at a frequency of 0.000228 in 1,515,790 control chromosomes in the GnomAD database, including 1 homozygotes. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_000535.7 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Benign. Variant got -7 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.000178 AC: 27AN: 151324Hom.: 0 Cov.: 31
GnomAD3 exomes AF: 0.000190 AC: 32AN: 168512Hom.: 0 AF XY: 0.000219 AC XY: 20AN XY: 91418
GnomAD4 exome AF: 0.000234 AC: 319AN: 1364466Hom.: 1 Cov.: 22 AF XY: 0.000249 AC XY: 169AN XY: 678008
GnomAD4 genome AF: 0.000178 AC: 27AN: 151324Hom.: 0 Cov.: 31 AF XY: 0.000149 AC XY: 11AN XY: 73844
ClinVar
Submissions by phenotype
not provided Uncertain:8
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The PMS2 c.2012C>T (p.Thr671Met) variant has been reported in the published literature in affected individuals with pancreatic cancer (PMIDs: 26483394 (2015), 27449771 (2016)), breast cancer (PMIDs: 25186627 (2015), 29785153 (2018), 31159747 (2019), 31422574 (2019), 33120919 (2020), 35402282 (2022), 37534630 (2023)), and colorectal cancer/suspected Lynch syndrome (PMIDs: 28135145 (2017), 34271781 (2021), 35372080 (2022)). This variant has been reported in individuals with breast cancer as well as in unaffected controls in a breast cancer association study (PMID: 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared/genes/PMS2)). The frequency of this variant in the general population, 0.00035 (29/83638 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 predictions that this variant is benign. Based on the available information, we are unable to determine the clinical significance of this variant. -
The PMS2 p.Thr671Met variant was identified in 3 of 260 proband chromosomes (frequency: 0.01) from individuals or families with breast cancer of Romanian ethnicity (Goidescu 2017). The variant was also identified in dbSNP (ID: rs587780046) as with uncertain significance allele; and in ClinVar and Clinvitae databases as benign by Ambry Genetics and uncertain significance by Invitae, Praxis fuer Humangenetik Tuebingen, Quest Diagnostics - Nichols Institute San Juan Capistrano, Fulgent Genetics, GeneDx and Pathway Genomics. The variant was not identified in GeneInsight-COGR, Cosmic, MutDB, Insight Colon Cancer Gene Variant Database, Zhejiang Colon Cancer Database, Mismatch Repair Genes Variant Database, Insight Hereditary Tumors Database, databases. The variant was identified in control databases in 34 of 195042 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 other in 3 of 5030 chromosomes (freq: 0.0006), European Non-Finnish in 27 of 81252 chromosomes (freq: 0.0003), East Asian in 2 of 13498 chromosomes (freq: 0.0001), and South Asian in 2 of 23600 chromosomes (freq: 0.0001), while the variant was not observed in the African, Latino, Ashkenazi Jewish, European Finnish, populations. The p.Thr671 residue is not conserved in mammals and computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) provide inconsistent predictions regarding the impact to the protein; this information is not very predictive of pathogenicity. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer, HumanSpliceFinder) do not predict a difference in splicing. In summary, based on the above information the clinical significance of this variant cannot be determined with certainty at this time. This variant is classified as a variant of uncertain significance. -
BP4 -
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In silico analysis indicates that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 26483394, 31422574, 22229248, 27449771, 28135145, 29101607, 29785153, 25186627, 31159747, 30613976, 34271781, 33120919, 33939675, 26321251, 35372080, 35402282, 30113427, 35089076, 33471991, 37534630, 35263119, 34326862, 11292842) -
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The PMS2 c.2012C>T; p.Thr671Met variant (rs587780046) is reported in the literature in individuals with personal and/or family history of cancer (Bhai 2021, Rizzolo 2019, Tsaousis 2019, Zhu 2021). This variant is also reported in ClinVar (Variation ID: 127770). It is observed in the general population with an overall allele frequency of 0.02% (35/199754 alleles) in the Genome Aggregation Database (v2.1.1). Computational analyses predict that this variant is neutral (REVEL: 0.109). Due to limited information, the clinical significance of this variant is uncertain at this time. References: Bhai P et al. Analysis of Sequence and Copy Number Variants in Canadian Patient Cohort With Familial Cancer Syndromes Using a Unique Next Generation Sequencing Based Approach. Front Genet. 2021 Jul 13;12:698595. PMID: 34326862. Rizzolo P et al. Insight into genetic susceptibility to male breast cancer by multigene panel testing: Results from a multicenter study in Italy. Int J Cancer. 2019 Jul 15;145(2):390-400. PMID: 30613976. Tsaousis GN et al. Analysis of hereditary cancer syndromes by using a panel of genes: novel and multiple pathogenic mutations. BMC Cancer. 2019 Jun 3;19(1):535. PMID: 31159747. Zhu H et al. Genetic Variants in Patients With a Family History of Pancreatic Cancer: Impact of Multigene Panel Testing. Pancreas. 2021 Apr 1;50(4):602-606. PMID: 33939675. -
Lynch syndrome 4 Uncertain:5
This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. However, the evidence from the literature, in combination with allele frequency data from public databases where available, was not sufficient to rule this variant in or out of causing disease. Therefore, this variant is classified as a variant of unknown significance. -
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The PMS2 c.2012C>T (p.Thr671Met) missense change has a maximum subpopulation frequency of 0.035% in gnomAD v2.1.1 (https://gnomad.broadinstitute.org/variant/7-6022617-G-A?dataset=gnomad_r2_1). This variant is located in exon 12 of the PMS2 gene and data in this region are not considered reliable due to high pseudogene homology. This variant was reported in 2 of 1,058 individuals with colorectal cancer (PMID: 28135145). One of the individuals also harbored a pathogenic germline variant in MUTYH (c.891+3A>C). The tumor of this individual was determined to be MMR proficient and microsatellite stable (PMID: 28135145). This variant has also been reported in individuals with breast cancer (PMID: 25186627, 29785153, 30613976) and pancreatic cancer (PMID: 26483394, 27449771). In silico tools are not in agreement about the effect of this variant on protein function, but to our knowledge these predictions have not been confirmed by functional assays. In summary, this variant meets criteria to be classified as of uncertain significance based on the ACMG/AMP criteria: not criteria met. -
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Hereditary cancer-predisposing syndrome Uncertain:4Benign:1
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This alteration is classified as 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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This missense variant replaces threonine with methionine at codon 671 of the PMS2 protein. Computational prediction suggests that this variant may not impact protein structure and function (internally defined REVEL score threshold <= 0.5, PMID: 27666373). To our knowledge, functional studies have not been reported for this variant. This variant has been reported in individuals affected with breast/ovarian cancer (PMID: 25186627, 29785153, 31422574, 33120919), colorectal (PMID: 28135145), or pancreatic cancer (PMID: 2648339). This variant has been identified in 35/199754 chromosomes in the general population by the Genome Aggregation Database (gnomAD). However, this observed allele frequency is not considered reliable, because the gnomAD dataset does not disambiguate possible interference from homologous sequences in the PMS2CL pseudogene. 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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not specified Uncertain:2Benign:1
DNA sequence analysis of the PMS2 gene demonstrated a sequence change, c.2012C>T, in exon 12 that results in an amino acid change, p.Thr671Met. This sequence change has been described in gnomAD with a frequency of 0.035% in the Non-Finnish European sub-population (dbSNP rs587780046). The p.Thr671Met change affects a poorly conserved amino acid residue located in a domain of the PMS2 protein that is not known to be functional. In-silico pathogenicity prediction tools (SIFT, PolyPhen2, Align GVGD, REVEL) provide contradictory results for the p.Thr671Met substitution. The c.2012C>T sequence change has been reported in the literature in individuals affected with breast cancer, colorectal cancer or pancreatic cancer (PMIDs: 25186627, 26483394, 27449771, 28135145, 29785153, 30613976, 31159747) but has also been reported in individuals without a cancer diagnosis (PMID: 31422574). One of the reported colorectal cancer patients also carried a pathogenic variant in the KRAS gene (c.34G>T, p.Gly12Cys). The patient's tumor was determined to be MMR proficient and microsatellite stable (PMID: 28135145). Due to these contrasting evidences and the lack of functional studies, the clinical significance of the p.Thr671Met change remains unknown at this time. -
Variant summary: PMS2 c.2012C>T (p.Thr671Met) results in a non-conservative amino acid change in 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 0.00019 in 168512 control chromosomes. The observed variant frequency is approximately 3 fold of the estimated maximal expected allele frequency for a pathogenic variant in PMS2 causing Hereditary Nonpolyposis Colorectal Cancer phenotype (7.1e-05). However, this PMS2 locus is highly homologous to PMS2 pseudogene and the technology utilized for these datasets does not rule out pseudogene interference, therefore these data might not be reliable. c.2012C>T has been reported in the literature in individuals affected with breast cancer, colorectal cancer, ovarian cancer or pancreatic cancer (e.g. Tung 2015, Hu 2016, Yang 2016, Yurgelun 2017, Goidescu 2018, Rizzolo_2019, Tsaousis_2019, Duzkale_2021, Sahin_2022, Abdel-Razeq_2022, Dorling_2021, Delahunty_2022,) but has also been reported in individual(s) without a cancer diagnosis (e.g. Kraemer_2019). One of the reported colorectal cancer patients had a co-occurring pathogenic variant (KRAS c.34G>T, p.Gly12Cys) while the patient's tumor was determined to be MMR proficient and microsatellite stable (Yurgelun_2017). These reports do not provide unequivocal conclusions about association of the variant with Hereditary Nonpolyposis Colorectal Cancer. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 35402282, 35263119, 33471991, 34271781, 29785153, 35372080, 26483394, 31422574, 30613976, 35089076, 31159747, 25186627, 27449771, 28135145, 33120919, 30113427). ClinVar contains an entry for this variant (Variation ID: 127770). Based on the evidence outlined above, the variant was classified as uncertain significance. -
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Breast and/or ovarian cancer Uncertain:1
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Lynch syndrome 4;C5399763:Mismatch repair cancer syndrome 1 Uncertain:1
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Lynch syndrome 1 Uncertain:1
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Hereditary nonpolyposis colorectal neoplasms Benign:1
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Hereditary breast ovarian cancer syndrome Benign:1
According to the ClinGen InSiGHT ACMG PMS2 v1.0.0 criteria we chose these criteria: BP4 (supporting benign): REVEL : Score: 0.109, BS1 (strong benign): Grpmax Filtering AF (gAD v3) = 0.0002305 (>0.0001) -
Lynch syndrome;C5436817:Mismatch repair cancer syndrome 4 Other:1
Variant interpreted as Uncertain significance and reported on 07-28-2020 by Lab Invitae. GenomeConnect-Invitae Patient Insights Network assertions are reported exactly as they appear on the patient-provided report from the testing laboratory. Registry team members make no attempt to reinterpret the clinical significance of the variant. Phenotypic details are available under supporting information. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at