rs63751107

Variant names:

• chr2-47403288-A-C
• rs63751107
• NM_000251.3:c.97A>C

Your query was ambiguous. Multiple possible variants found:

• chr2-47403288-A-C
• chr2-47403288-A-G
• chr2-47403288-A-T

Variant summary

Our verdict is Uncertain significance. The variant received 3 ACMG points: 4P and 1B. PP3_Strong BP6

The NM_000251.3(MSH2):​c.97A>C​(p.Thr33Pro) variant causes a missense change. The variant allele was found at a frequency of 0.0000587 in 1,601,442 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic 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. T33A) has been classified as Uncertain significance.

• Frequency:
  • Genomes: 𝑓 0.000092 (0 hom., cov: 33)
  • Exomes 𝑓: 0.000055 (0 hom.)
• Consequence: MSH2 NM_000251.3 missense
• Clinical Significance: Conflicting classifications of pathogenicity criteria provided, conflicting classifications U:10 B:3
• Conservation: PhyloP100: 6.72
• Publications: 13 publications found

Genes affected

MSH2 (HGNC:7325): (mutS homolog 2) This locus is frequently mutated in hereditary nonpolyposis colon cancer (HNPCC). When cloned, it was discovered to be a human homolog of the E. coli mismatch repair gene mutS, consistent with the characteristic alterations in microsatellite sequences (RER+ phenotype) found in HNPCC. Two transcript variants encoding different isoforms have been found for this gene. [provided by RefSeq, Apr 2012]

MSH2 Gene-Disease associations (from GenCC):

• Lynch syndrome

  Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: G2P, ClinGen, Orphanet
• Lynch syndrome 1

  Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Genomics England PanelApp, Ambry Genetics
• Muir-Torre syndrome

  Inheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Genomics England PanelApp, Orphanet, G2P
• mismatch repair cancer syndrome 1

  Inheritance: AR Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
• mismatch repair cancer syndrome 2

  Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), G2P
• ovarian cancer

  Inheritance: AD Classification: STRONG Submitted by: Genomics England PanelApp
• malignant pancreatic neoplasm

  Inheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
• prostate cancer

  Inheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
• rhabdomyosarcoma

  Inheritance: AR Classification: MODERATE Submitted by: Genomics England PanelApp
• breast cancer

  Inheritance: AD Classification: NO_KNOWN Submitted by: Ambry Genetics
• hereditary breast carcinoma

  Inheritance: AD Classification: NO_KNOWN Submitted by: ClinGen

ACMG classification

Our verdict: Uncertain_significance. The variant received 3 ACMG points.

• PP3: MetaRNN computational evidence supports a deleterious effect, 0.976
• BP6: Variant 2-47403288-A-C is Benign according to our data. Variant chr2-47403288-A-C is described in ClinVar as Conflicting_classifications_of_pathogenicity. ClinVar VariationId is 91267.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	MANE	Protein	UniProt
MSH2	NM_000251.3	c.97A>C	p.Thr33Pro	missense_variant	Exon 1 of 16	ENST00000233146.7	NP_000242.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	Exon rank	TSL	MANE	Protein	Appris	UniProt
MSH2	ENST00000233146.7	c.97A>C	p.Thr33Pro	missense_variant	Exon 1 of 16	1	NM_000251.3	ENSP00000233146.2

Frequencies

GnomAD3 genomes AF: 0.0000919 AC: 14 AN: 152260 Hom.: 0 Cov.: 33

Gnomad AFR AF: 0.00

Gnomad AMI AF: 0.00

Gnomad AMR AF: 0.000654

Gnomad ASJ AF: 0.00

Gnomad EAS AF: 0.00

Gnomad SAS AF: 0.00

Gnomad FIN AF: 0.00

Gnomad MID AF: 0.00

Gnomad NFE AF: 0.0000588

Gnomad OTH AF: 0.00

GnomAD2 exomes AF: 0.0000673 AC: 15 AN: 222782 AF XY: 0.0000824

Gnomad AFR exome AF: 0.00

Gnomad AMR exome AF: 0.000128

Gnomad ASJ exome AF: 0.00

Gnomad EAS exome AF: 0.00

Gnomad FIN exome AF: 0.00

Gnomad NFE exome AF: 0.000110

Gnomad OTH exome AF: 0.00

GnomAD4 exome AF: 0.0000552 AC: 80 AN: 1449182 Hom.: 0 Cov.: 31 AF XY: 0.0000472 AC XY: 34 AN XY: 719814

African (AFR) AF: 0.00 AC: 0 AN: 33410

American (AMR) AF: 0.0000712 AC: 3 AN: 42120

Ashkenazi Jewish (ASJ) AF: 0.00 AC: 0 AN: 25716

East Asian (EAS) AF: 0.00 AC: 0 AN: 39246

South Asian (SAS) AF: 0.00 AC: 0 AN: 83800

European-Finnish (FIN) AF: 0.00 AC: 0 AN: 51428

Middle Eastern (MID) AF: 0.00 AC: 0 AN: 5600

European-Non Finnish (NFE) AF: 0.0000686 AC: 76 AN: 1107918

Other (OTH) AF: 0.0000167 AC: 1 AN: 59944

GnomAD4 genome AF: 0.0000919 AC: 14 AN: 152260 Hom.: 0 Cov.: 33 AF XY: 0.000134 AC XY: 10 AN XY: 74390

African (AFR) AF: 0.00 AC: 0 AN: 41474

American (AMR) AF: 0.000654 AC: 10 AN: 15290

Ashkenazi Jewish (ASJ) AF: 0.00 AC: 0 AN: 3470

East Asian (EAS) AF: 0.00 AC: 0 AN: 5198

South Asian (SAS) AF: 0.00 AC: 0 AN: 4834

European-Finnish (FIN) AF: 0.00 AC: 0 AN: 10628

Middle Eastern (MID) AF: 0.00 AC: 0 AN: 316

European-Non Finnish (NFE) AF: 0.0000588 AC: 4 AN: 68044

Other (OTH) AF: 0.00 AC: 0 AN: 2094

Alfa AF: 0.0000386 Hom.: 0

Bravo AF: 0.0000567

ExAC AF: 0.0000331 AC: 4

ClinVar

Significance: Conflicting classifications of pathogenicity

Submissions summary: Uncertain:10 Benign:3

Revision: criteria provided, conflicting classifications

Submissions by phenotype

Lynch syndrome 1 Uncertain:2 Benign:1

Dec 03, 2024

Myriad Genetics, Inc.

Significance: Likely benign

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This variant is considered likely benign. This variant is strongly associated with less severe personal and family histories of cancer, typical for individuals without pathogenic variants in this gene [PMID: 27363726]. -

Oct 23, 2023

Baylor Genetics

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Feb 27, 2017

Counsyl

Significance: Uncertain significance

Review Status: no assertion criteria provided

Collection Method: clinical testing

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 specified Uncertain:2

Jan 31, 2019

Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The p.Thr33Pro variant in MSH2 has been reported in 4 individuals with Lynch Syndrome-related cancers (Hedge 2005, Hampel 2006, Ollila 2006, Chubb 2015). Functional studies (microsatellite instability, immunohistochemistry, mismatch repair, expression and interaction assays) provide conflicting evidence on whether the p.Thr33Pro variant impacts protein function (Ollila 2006, Ollila 2008, Kansikas 2011, Martinez 2010). This variant has also been identified in 4/32028 Latino chromosomes by the Genome Aggregation Database (GnomAD, http://gnomad.broadinstitute.org). Computational prediction tools and conservation analysis suggest that the p.Thr33Pro variant may impact the protein, though this information is not predictive enough to determine pathogenicity. In addition, this variant was classified as a variant of uncertain significance on Sept. 5, 2013 by the ClinGen-approved InSiGHT expert panel (ClinVar SCV000107811.2). In summary, the clinical significance of the p.Thr33Pro variant is uncertain. -

Sep 23, 2024

Women's Health and Genetics/Laboratory Corporation of America, LabCorp

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Variant summary: MSH2 c.97A>C (p.Thr33Pro) results in a non-conservative amino acid change located in the DNA mismatch repair protein MutS-like, N-terminal of the encoded protein sequence. Five of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 6.7e-05 in 222782 control chromosomes, predominantly at a frequency of 0.00013 within the Latino subpopulation in the gnomAD database. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.97A>C has been reported in the literature in individuals affected with Lynch Syndrome, endometrial cancer and colorectal cancer (Hegde_2005, Hampel_2006, Ollila_2006, Chubb_2015, Li_2020, Singh_2020), without strong evidence for causality. Several publications have reported functional studies of the variant showing: normal interaction with MSH6 but decreased in vitro MMR activity (Ollila_2006), weak MMR defect (Martinez_2010), while other pubications reported the variant to be neutral via assays that measured proportions of cells that undergo death following exposure to a methylating agent (Bouvet_2019) and in human cell line models in which MSH2 deletion was complemented by libraries of variants comprising nearly every possible MSH2 missense allele (Jia_2021). The following publications have been ascertained in the context of this evaluation (PMID: 30998989, 25559809, 16885385, 16237223, 33357406, 31391288, 20176959, 17101317, 32634176, 26580448). ClinVar contains an entry for this variant (Variation ID: 91267). Based on the evidence outlined above, the variant was classified as uncertain significance. -

not provided Uncertain:2

Dec 14, 2023

GeneDx

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

Published functional studies demonstrate no damaging effect: interaction with MSH6, expression in colon carcinoma cells, protein stability, mismatch binding, mismatch repair activity, and cell survival similar to wild type (PMID: 17101317, 18951462, 20176959, 30998989, 33357406, 26951660); Observed in patients with Lynch-related cancers; however, available tumor studies were inconsistent (PMID: 16885385, 25559809, 17101317, 32634176); 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: 17594722, 17101317, 18951462, 25559809, 22949387, 21120944, 16237223, 16885385, 17370310, 18383312, 20176959, 26951660, 30998989, 33357406, 35688932, 32634176, 26580448, 31391288, 32885271, 18822302) -

Sep 09, 2024

Quest Diagnostics Nichols Institute San Juan Capistrano

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

The MSH2 c.97A>C (p.Thr33Pro) variant has been reported in the published literature in individuals with colorectal cancer (PMID: 25559809 (2015)), endometrial cancer (PMID: 16885385 (2006)), and in families with Lynch syndrome (PMIDs: 18951462 (2008), 17101317 (2006), and 16237223 (2005)). In a large scale breast cancer association study, this variant has been observed in breast cancer cases as well as reportedly healthy individuals (PMID: 33471991 (2021), see also LOVD (http://databases.lovd.nl/shared)). Functional assays were inconclusive, but suggest that this variant may cause reduced protein activity (PMIDs: 30998989 (2019), 20176959 (2010), 18951462 (2008), and 17101317 (2006)). The frequency of this variant in the general population, 0.00012 (4/32028 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 damaging. Based on the available information, we are unable to determine the clinical significance of this variant. -

Hereditary cancer-predisposing syndrome Uncertain:1 Benign:1

May 26, 2022

Ambry Genetics

Significance: Benign

Review Status: criteria provided, single submitter

Collection Method: clinical testing

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. -

Sep 27, 2023

Color Diagnostics, LLC DBA Color Health

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This missense variant replaces threonine with proline at codon 33 of the MSH2 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). Functional studies reported this variant as partially functional in mismatch repair assay in vitro (PMID: 17101317) and in yeast (PMID: 20176959). This variant is functional in a methylation tolerance assay (PMID: 30998989) and does not impact MSH2 function in a 6-thioguanine sensitivity assay in haploid human cells (internally defined LOF score threshold <= -1.32, PMID: 33357406). This variant has been reported in individuals affected with Lynch syndrome-associated cancers (PMID: 16237223, 16885385, 17101317, 25559809, 32634176). This variant has been identified in 16/254182 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. -

Lynch syndrome Uncertain:1

Jan 11, 2024

All of Us Research Program, National Institutes of Health

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

This missense variant replaces threonine with proline at codon 33 of the MSH2 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). Functional studies reported this variant as partially functional in mismatch repair assay in vitro (PMID: 17101317) and in yeast (PMID: 20176959). This variant is functional in a methylation tolerance assay (PMID: 30998989) and does not impact MSH2 function in a 6-thioguanine sensitivity assay in haploid human cells (internally defined LOF score threshold <= -1.32, PMID: 33357406). This variant has been reported in an individual affected with rectal cancer (PMID: 25559809) and at least two individuals affected with endometrial cancer (PMID: 16885385, 17101317, 32634176). This variant has been identified in 16/254182 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. -

Malignant tumor of breast Uncertain:1

-

Department of Pathology and Laboratory Medicine, Sinai Health System

Significance: Uncertain significance

Review Status: no assertion criteria provided

Collection Method: clinical testing

The MSH2 p.Thr33Pro variant was identified in 3 of 2424 proband chromosomes (frequency: 0.001) from individuals with colon and endometrial cancer (Hegde 2005, Hampel 2006, Chubb 2015). The variant was identified in dbSNP (rs63751107) as “with uncertain significance allele”, ClinVar (classified as "uncertain significance" by Invitae, GeneDx and five other submitters) and UMD-LSDB (observed 2x). The variant was identified in control databases in 14 of 248,976 chromosomes at a frequency of 0.00006 (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: Latino in 4 of 31,200 chromosomes (freq: 0.0001), European in 10 of 113,324 chromosomes (freq: 0.00009), but not in the African, Other, Ashkenazi Jewish, East Asian, Finnish, and South Asian populations. A cell line derived from a patient with the observed variant had normal levels of MSH2 and MSH6 protein as observed on a western blot (Ollila 2006). In an in vitro mismatch repair assay, the variant was generated by site-directed mutagenesis and decreased MMR efficiency by 23% compared to wild type (Ollila 2006). The variant is present in the DNA binding domain of MSH2 and in another study was demonstrated to bind mismatches as efficiently as wild type, and had a slightly reduced DNA release. These observations led to the conclusion that the variant causes a slight defect in MMR efficiency, and based on these experiments, it is unclear if the variant is pathogenic (Ollila 2008). The p.Thr33 residue is conserved across mammals and other organisms, and four out of five computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) suggest that the variant may impact the protein; however, this information is not predictive enough to assume pathogenicity. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer) 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. -

Muir-Torré syndrome;C2936783:Lynch syndrome 1;C5436806:Mismatch repair cancer syndrome 2 Uncertain:1

Apr 18, 2022

Fulgent Genetics, Fulgent Genetics

Significance: Uncertain significance

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Hereditary nonpolyposis colorectal neoplasms Benign:1

Jan 26, 2025

Labcorp Genetics (formerly Invitae), Labcorp

Significance: Likely benign

Review Status: criteria provided, single submitter

Collection Method: clinical testing

- -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	0.97
BayesDel_addAF	Pathogenic	0.32	D
BayesDel_noAF	Pathogenic	0.45
CADD	Pathogenic	27
DANN	Uncertain	0.99
DEOGEN2	Pathogenic	0.89	D;.;.
Eigen	Uncertain	0.42
Eigen_PC	Uncertain	0.30
FATHMM_MKL	Uncertain	0.95	D
LIST_S2	Uncertain	0.96	D;D;D
M_CAP	Pathogenic	0.82	D
MetaRNN	Pathogenic	0.98	D;D;D
MetaSVM	Uncertain	0.63	D
MutationAssessor	Pathogenic	3.7	H;.;.
PhyloP100		6.7
PrimateAI	Pathogenic	0.81	D
PROVEAN	Pathogenic	-4.6	D;.;D
REVEL	Pathogenic	0.82
Sift	Uncertain	0.0010	D;.;D
Sift4G	Uncertain	0.0030	D;.;D
Polyphen		1.0	D;.;D
Vest4		0.83
MutPred		0.90		Loss of phosphorylation at T33 (P = 0.0579);Loss of phosphorylation at T33 (P = 0.0579);Loss of phosphorylation at T33 (P = 0.0579);
MVP		0.99
MPC		0.032
ClinPred		0.91	D
GERP RS		3.3
PromoterAI		0.0057	Neutral
Varity_R		0.99
gMVP		0.84
Mutation Taster		=10/90	disease causing

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.0		Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Other links and lift over

dbSNP: rs63751107; hg19: chr2-47630427;