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MSH6
Final classification
VUS
MSH6 c.3412G>A · p.Gly1138Arg
MSH6

PM2_Supporting is met: the variant is absent from gnomAD v4.1 (0/1,614,568 alleles) and gnomAD v2.1, meeting the VCEP threshold of allele frequency <0.00002.

Gene
MSH6
Transcript
NM_000179.2
HGVS · transcript:coding
NM_000179.2:c.3412G>A
Consequence
N/A
GRCh38
chr2:47803659 G>A
GRCh37
chr2:48030798 G>A
Basis ClinGen InSiGHT Hereditary Colorectal Cancer/Polyposis Expert Panel Specifications to the ACMG/AMP Variant Interpretation Guidelines for MSH6 Version 2.0.0 v2.0.0 criteria-combination framework was evaluated deterministically with applied criteria: PM2 supporting, PP3 moderate; no rule matched the adjudicated criteria.
ClinGen InSiGHT Hereditary Colorectal Cancer/Polyposis Expert Panel Specifications to the ACMG/AMP Variant Interpretation Guidelines for MSH6 Version 2.0.0 v2.0.0 criteria-combination framework was evaluated deterministically with applied criteria: PM2 supporting, PP3 moderate; no rule matched the adjudicated criteria.
Classification rationale
PM2PP3 VUS
MSH6 c.3412G>A

PM2_Supporting is met: the variant is absent from gnomAD v4.1 (0/1,614,568 alleles) and gnomAD v2.1, meeting the VCEP threshold of allele frequency <0.00002.1 PP3_Moderate is met: the HCI prior probability of pathogenicity for c.3412G>A (p.G1138R) is 0.9617, exceeding the VCEP PP3_Moderate threshold of >0.81. REVEL score is 0.947, consistent with a deleterious prediction.2 PVS1 is not applicable: this is a missense variant (p.Gly1138Arg), not a null variant, and SpliceAI predicts no splice impact (max delta = 0.01).3 PS3 is not met: no calibrated functional assay data exists for p.Gly1138Arg in the VCEP functional assay documentation or published literature.4 PS1, PS2, PM5, PP1, PP4, BA1, BS1, BS2, BS3, BS4, BP4, BP5 are not met due to absence of supporting evidence.5 PS4, PS5, PM1, PM6, PP2, PP5, BP1, BP2, BP3, BP6, BP7, PM3, PM4 are not applicable per the InSiGHT MMR VCEP v2.0.0 specifications or because the variant class does not meet the criterion definition.6

PM2 + PP3 VUS
2 hci_priorrevelcspec ↗
4 vcep_functional_assay_svi_documentation_mmr
Gene diagram · NM_000179.2 · variants mapped to exon structure
MSH6 NM_000179.2
Fetching transcript structure from UCSC…
Applied criteria · 2 met · select any tile
Met
Not met
Not assessed
N/A
Strength very strong supporting
Pathogenic evidence
PVS
PS
PM
PP
Benign evidence
BA
BS
BP
Rationale
Select a criterion.
Sources
Evidence used
    Gaps remaining
      Rule
      Research & evidence
      Population frequency
      gnomAD v4.1 screenshot
      gnomAD v4.1
      gnomAD v2.1 screenshot
      gnomAD v2.1
      Population frequency
      Absent from gnomAD v4.1.
      Absent from gnomAD v2.1.
      Absent from gnomAD-Canada v1.0.
      ClinVar screenshot
      ClinVar
      This variant has been reported in ClinVar as Uncertain significance (2 clinical laboratories). (ClinVarID = 650516)
      SpliceAI screenshot
      In silico
      SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.947. BayesDel score = 0.451433. HCI prior probability for pathogenicity = 0.9617. MAPP score = 36.52. Custom PP2 score = 0.999.
      Functional / OncoKB screenshot
      Functional Unknown Oncogenic Effect
      OncoKB did not identify variant-specific reviewed functional evidence for this variant; gene-level curated context is available for reviewer follow-up. MSH6, a DNA mismatch repair protein, is frequently mutated in colorectal, small bowel, and endometrial cancers.
      OncoKB ↗
      COSMIC screenshot
      COSMIC
      Cancer hotspots screenshot
      Cancer hotspots
      Somatic evidence Not in COSMIC / hotspots
      COSMIC
      This variant does not lie in a statistically significant hotspot. This variant has not previously been reported in somatic cancers (COSMIC).
      Hotspots
      This variant does not lie in a statistically significant hotspot.
      Literature · 2 PMIDs triaged · 1 high-priority
      2papers screened
      Papers triaged by theme: functional/splicing/segregation/case_observation. high_priority_papers include abstract snippets. Use these to support PS3/BS3/PS4/PP1/PP3/PP5.
      25394175 ↗ case observation
      A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment.
      The practice guidelines of the American College of Medical Genetics and Genomics (ACMG) and the National Society of Genetic Counselors (NSGC) are developed by members of the ACMG and NSGC to assist medical geneticists, genetic counselors, and other health-care providers in making decisions about appropriate management of genetic concerns, including access to and/or delivery of services. Each pract
      PP5PS4
      28492532 ↗ background review
      Sherloc: a comprehensive refinement of the ACMG-AMP variant classification criteria.
      PP5PS4
      Sources & reference links
      9Sources
      CSpec VCEP
      ClinVar
      gnomAD v2.1
      gnomAD v4.1
      gnomAD-Canada
      SpliceAI
      OncoKB
      COSMIC
      Cancer hotspots