rs876660634

Positions:

• chr10-87925551-A-C
• chr10-87925551-A-G
• chr10-87925551-A-T

Variant summary

Our verdict is Pathogenic. Variant got 13 ACMG points: 13P and 0B. PM1 PM2 PM5 PP2 PP3_Strong PP5_Moderate

The NM_000314.8(PTEN):​c.203A>C​(p.Tyr68Ser) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 12/21 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. Y68?) has been classified as Pathogenic.

• Frequency: Genomes: not found (cov: 32)
• Consequence: PTEN NM_000314.8 missense
• Clinical Significance: Likely pathogenic criteria provided, single submitter P:2
• Conservation: PhyloP100: 8.65

Genes affected

PTEN (HGNC:9588): (phosphatase and tensin homolog) This gene was identified as a tumor suppressor that is mutated in a large number of cancers at high frequency. The protein encoded by this gene is a phosphatidylinositol-3,4,5-trisphosphate 3-phosphatase. It contains a tensin like domain as well as a catalytic domain similar to that of the dual specificity protein tyrosine phosphatases. Unlike most of the protein tyrosine phosphatases, this protein preferentially dephosphorylates phosphoinositide substrates. It negatively regulates intracellular levels of phosphatidylinositol-3,4,5-trisphosphate in cells and functions as a tumor suppressor by negatively regulating AKT/PKB signaling pathway. The use of a non-canonical (CUG) upstream initiation site produces a longer isoform that initiates translation with a leucine, and is thought to be preferentially associated with the mitochondrial inner membrane. This longer isoform may help regulate energy metabolism in the mitochondria. A pseudogene of this gene is found on chromosome 9. Alternative splicing and the use of multiple translation start codons results in multiple transcript variants encoding different isoforms. [provided by RefSeq, Feb 2015]

ACMG classification

Verdict is Pathogenic. Variant got 13 ACMG points.

• PM1: In a strand (size 8) in uniprot entity PTEN_HUMAN there are 7 pathogenic changes around while only 0 benign (100%) in NM_000314.8
• PM2: Very rare variant in population databases, with high coverage
• PM5: Other missense variant is known to change same aminoacid residue: Variant chr10-87925550-TAC-TT is described in Lovd as [Pathogenic].
• PP2: Missense variant in gene, where missense usually causes diseases (based on misZ statistic), PTEN. . Gene score misZ 3.4883 (greater than the threshold 3.09). Trascript score misZ 4.1129 (greater than threshold 3.09). GenCC has associacion of gene with Lhermitte-Duclos disease, Bannayan-Riley-Ruvalcaba syndrome, Proteus syndrome, macrocephaly-autism syndrome, Cowden syndrome 1, Cowden disease, Proteus-like syndrome, leiomyosarcoma, activated PI3K-delta syndrome, PTEN hamartoma tumor syndrome, glioma susceptibility 2, renal cell carcinoma.
• PP3: MetaRNN computational evidence supports a deleterious effect, 0.986
• PP5: Variant 10-87925551-A-C is Pathogenic according to our data. Variant chr10-87925551-A-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 481032.Status of the report is criteria_provided_single_submitter, 1 stars.

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	MANE	Protein	UniProt
PTEN	NM_000314.8	c.203A>C	p.Tyr68Ser	missense_variant	3/9	ENST00000371953.8	NP_000305.3
PTEN	NM_001304717.5	c.722A>C	p.Tyr241Ser	missense_variant	4/10		NP_001291646.4
PTEN	NM_001304718.2	c.-540-5495A>C		intron_variant			NP_001291647.1

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	TSL	MANE	Protein	Appris	UniProt
PTEN	ENST00000371953.8	c.203A>C	p.Tyr68Ser	missense_variant	3/9	1	NM_000314.8	ENSP00000361021	P1

Frequencies

GnomAD3 genomes Cov.: 32

GnomAD4 exome Cov.: 30

GnomAD4 genome Cov.: 32

ClinVar

Significance: Likely pathogenic

Submissions summary: Pathogenic:2

Revision: criteria provided, single submitter

Submissions by phenotype

Cowden syndrome 1 Pathogenic:1

Likely pathogenic, no assertion criteria provided

clinical testing

Biochemical Molecular Genetic Laboratory, King Abdulaziz Medical City

Feb 05, 2020

- -

Hereditary cancer-predisposing syndrome Pathogenic:1

Likely pathogenic, criteria provided, single submitter

clinical testing

Ambry Genetics

Dec 22, 2016

The p.Y68S variant (also known as c.203A>C), located in coding exon 3 of the PTEN gene, results from an A to C substitution at nucleotide position 203. The tyrosine at codon 68 is replaced by serine, an amino acid with dissimilar properties. Similar alterations have been reported at this position: p.Y68C, p.Y68H, p.Y68D. The p.Y68C alteration was previously reported in a woman diagnosed with thyroid cancer at age 46 and breast cancer at age 57 (Ngeow J, J. et al. Clin. Endocrinol. Metab. 2011 Dec;96(12):E2063-71; Ngeow J et al. J. Clin. Oncol. 2014 Jun;32(17):1818-24). Functional analyses of p.Y68C in peripheral blood T cells isolated from a 5 year old boy with macrocephaly, mild developmental delay and immunodeficiency showed reduced PTEN protein expression and increased AKT and S6 phosphorylation (Browning MJ et al. J. Med. Genet. 2015 Aug). In addition, p.Y68 is located in a putative ATP-binding site, and p.Y68C is associated with an increase in PTEN nuclear localization compared to wild type controls (Lobo GP et al. Hum. Mol. Genet. 2009 Aug;18(15):2851-62). The p.Y68H alteration has been identified in individuals meeting clinical diagnostic criteria for Bannayan-Zonana syndrome (BZS) and Cowden syndrome (Marsh, DJ. Hum Mol Genet. 1998 Mar;7(3):507-15; Lobo, GP. Hum Mol Genet. 2009 Aug 1;18(15):2851-62) and another patient with suspected PTHS (Pilarski, R. J Med Genet. 2011 Aug;48(8):505-12). Functional analyses have demonstrated that the p.Y68H variant impairs PTEN protein function and localization (Lobo, GP. Hum Mol Genet. 2009 Aug 1;18(15):2851-62; He, X. Hum Mol Genet. 2011 Jan 1;20(1):80-9). Another alteration at this position, p.Y68D, was reported in a boy with a clinical diagnosis of proteus syndrome and his mother with clinical features of Cowden syndrome (Loffeld A et al. Br. J. Dermatol.;154 (6):1194-8). Based on internal structural analysis, the p.Y68S alteration is more destabilizing than similar nearby pathogenic alterations (Lee JO et al. Cell, 1999 Oct;99:323-34). This amino acid position is highly conserved in available vertebrate species. In addition, p.Y68S is predicted to be probably damaging and deleterious by PolyPhen and SIFT in silico analyses, respectively. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	1.0
BayesDel_addAF	Pathogenic	0.57	D
BayesDel_noAF	Pathogenic	0.58
CADD	Pathogenic	32
DANN	Uncertain	0.99
DEOGEN2	Pathogenic	0.95	D
Eigen	Pathogenic	0.93
Eigen_PC	Pathogenic	0.86
FATHMM_MKL	Pathogenic	0.99	D
LIST_S2	Uncertain	0.86	D
M_CAP	Pathogenic	0.91	D
MetaRNN	Pathogenic	0.99	D
MetaSVM	Pathogenic	1.1	D
MutationAssessor	Pathogenic	3.4	M
MutationTaster	Benign	1.0	D
PrimateAI	Pathogenic	0.90	D
PROVEAN	Pathogenic	-8.7	D
REVEL	Pathogenic	0.99
Sift	Uncertain	0.0040	D
Sift4G	Pathogenic	0.0010	D
Polyphen		1.0	D
Vest4		0.96
MutPred		0.87		Gain of disorder (P = 0.023);
MVP		0.99
MPC		2.7
ClinPred		1.0	D
GERP RS		5.5
Varity_R		0.95
gMVP		0.99

Splicing

Name	Calibrated prediction	Score	Prediction
SpliceAI score (max)		0.030		Details are displayed if max score is > 0.2

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

Publications

LitVar

Other links and lift over

dbSNP: rs876660634; hg19: chr10-89685308;