rs786201851
Variant summary
Our verdict is Likely benign. The variant received -3 ACMG points: 0P and 3B. BP4_ModerateBP6
The NM_000535.7(PMS2):āc.1268C>Gā(p.Ala423Gly) variant causes a missense change. The variant allele was found at a frequency of 0.0000397 in 1,614,032 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts 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. A423D) has been classified as Uncertain significance.
Frequency
Consequence
NM_000535.7 missense
Scores
Clinical Significance
Conservation
Publications
- Lynch syndromeInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
- Lynch syndrome 4Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae), Genomics England PanelApp
- mismatch repair cancer syndrome 1Inheritance: AR Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
- mismatch repair cancer syndrome 4Inheritance: AR Classification: DEFINITIVE, STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae)
- malignant pancreatic neoplasmInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- ovarian cancerInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- Muir-Torre syndromeInheritance: AR Classification: MODERATE Submitted by: Genomics England PanelApp
- rhabdomyosarcomaInheritance: AR Classification: MODERATE Submitted by: Genomics England PanelApp
- breast cancerInheritance: AD Classification: LIMITED Submitted by: Ambry Genetics
- prostate cancerInheritance: AD Classification: LIMITED Submitted by: Ambry Genetics
- hereditary breast carcinomaInheritance: 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 |
|---|---|---|---|---|---|---|---|---|
| PMS2 | NM_000535.7 | c.1268C>G | p.Ala423Gly | missense_variant | Exon 11 of 15 | ENST00000265849.12 | NP_000526.2 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| PMS2 | ENST00000265849.12 | c.1268C>G | p.Ala423Gly | missense_variant | Exon 11 of 15 | 1 | NM_000535.7 | ENSP00000265849.7 |
Frequencies
GnomAD3 genomes AF: 0.0000854 AC: 13AN: 152168Hom.: 0 Cov.: 31 show subpopulations
GnomAD2 exomes AF: 0.0000279 AC: 7AN: 251004 AF XY: 0.0000221 show subpopulations
GnomAD4 exome AF: 0.0000349 AC: 51AN: 1461864Hom.: 0 Cov.: 34 AF XY: 0.0000440 AC XY: 32AN XY: 727230 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000854 AC: 13AN: 152168Hom.: 0 Cov.: 31 AF XY: 0.000121 AC XY: 9AN XY: 74322 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
not specified Uncertain:3
Variant summary: PMS2 c.1268C>G (p.Ala423Gly) results in a non-conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a damaging effect of the variant on protein function. The variant allele was found at a frequency of 2.8e-05 in 251004 control chromosomes (gnomAD). The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.1268C>G has been reported in the literature in an individual suspected of Lynch Syndrome who also had a co-occurring pathogenic variant in MLH1 (c.1852_1854del, p.Lys618del), providing supporting evidence for a benign role (Yurgelun_2015). It has also been reported in settings of multigene panel testing in individuals affected with breast cancer and pancreatic cancer (Young_2018, Niktin_2020). These reports do not provide unequivocal conclusions about association of the variant with Lynch Syndrome. 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: 32547938, 29945567, 25980754). Nine clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 and all classified the variant as uncertain significance. Based on the evidence outlined above, the variant was classified as uncertain significance. -
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not provided Uncertain:2Benign:1
The frequency of this variant in the general population, 0.00014 (18/128902 chromosomes, http://gnomad.broadinstitute.org), is uninformative in assessment of its pathogenicity. In the published literature, the variant has been reported to co-occur with an MLH1 variant in an individual with Lynch Syndrome (PMID: 25980754 (2015). Additionally, the variant has been reported in individuals with breast cancer (PMIDs: 32547938 (2020) and 33471991 (2021), see also LOVD (https://databases.lovd.nl/shared/variants/PMS2)) and healthy individuals (PMID: 33471991, see also LOVD (https://databases.lovd.nl/shared/variants/PMS2)). 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. -
PMS2: PS4:Supporting, BP1, BP5 -
In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Identified in an individual with pancreatic cancer and in an individual with a Lynch-associated cancer and/or polyps who also harbored a pathogenic MLH1 variant (Yurgelun et al., 2015; Young et al., 2018); Case control studies suggest this variant may be associated with breast cancer (Nikitin et al., 2020); This variant is associated with the following publications: (PMID: 27882345, 27363283, 25980754, 29945567, 32547938, 33471991) -
Hereditary cancer-predisposing syndrome Uncertain:2Benign:1
This alteration is classified as likely 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 alanine with glycine at codon 423 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 performed for this variant. This variant has been reported in one individual tested for Lynch syndrome in the literature, however this individual also harbored a pathogenic MLH1 mutation (PMID: 25980754). This variant has also been reported in 12/60466 cases and 9/53461 unaffected controls in a large breast cancer case-control study (PMID: 33471991). This variant has been identified in 19/282400 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 4 Uncertain:2Benign:1
This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score, this variant could not be ruled out of causing disease and therefore its association with disease required further investigation. A literature search was performed for the gene, cDNA change, and amino acid change (if applicable). No publications were found based on this search. This variant was therefore classified as a variant of unknown significance for this disease. -
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This variant is considered likely benign. This variant has been observed in trans with a known pathogenic variant in one or more individuals lacking clinical features consistent with gene-specific recessive disease. -
Lynch syndrome 4;C5436817:Mismatch repair cancer syndrome 4 Uncertain:1
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Hereditary nonpolyposis colorectal neoplasms Benign:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at