LYFE Sciences · Project HERA
Variant Interpretation · Classification Report
Generated: 2026-08-28
Case ID: NM_000264.5_c.324A_G_20260828_105058
Framework: ACMG/AMP 2015
Variant classification summary

NM_000264.5:c.324A>G

PTCH1  · NP_000255.2:p.(Ile108Met)  · NM_000264.5
GRCh37: chr9:98268759 T>C  ·  GRCh38: chr9:95506477 T>C
Gene: PTCH1 Transcript: NM_000264.5
Final call
VUS
PM2 supporting BS2 supporting
All criteria require review: For research and educational purposes only.
Gene
PTCH1
Transcript
NM_000264.5
Protein
NP_000255.2:p.(Ile108Met)
gnomAD AF
0.00016178421333201096 (v4.1)
ClinVar
Likely benign
OncoKB
Unknown Oncogenic Effect
Interpretation summary
Generated evidence synthesis
1
PM2 (Supporting): gnomAD v4.1 allele frequency 0.01618% is below the 0.1% rarity threshold.
2
BS2 (Supporting): one homozygous carrier in gnomAD v4.1 is inconsistent with a highly penetrant autosomal-dominant PTCH1 disorder.
3
VUS: PM2 and BS2 conflict at supporting strength, meeting no pathogenic or benign combination threshold under the generic ACMG/AMP 2015 rules.
Final determination: Under the generic ACMG/AMP 2015 fallback, one pathogenic supporting criterion (PM2) and one benign supporting criterion (BS2) are conflicting evidence that does not meet any definitive classification combination, resulting in VUS.
ACMG/AMP criteria review
Criteria shown when status is available
All criteria require review: For research and educational purposes only.
Criterion Status Rationale Evidence used
PVS1 N/A Not applicable: c.324A>G is a missense change, not a null variant class (nonsense, frameshift, or canonical splice-site).
pvs1_generic_framework generic_acmg_combination_rules
PS1 Not met Not met: the same protein change was reported in one proband but never established as pathogenic (inherited from an unaffected mother).
PMID:32074614
PS2 Not assessed Not assessed: no de novo occurrence is documented; the variant was inherited from the proband's unaffected mother.
PMID:32074614
PS3 Not assessed Not assessed: no validated variant-specific functional assay demonstrating a damaging effect was available.
oncokb PMID:32074614
PS4 Not assessed Not assessed: the variant was seen in one proband only, with no case-control or enrichment data.
PMID:32074614
PM1 Not met Not met: p.Ile108Met is not in a statistically significant cancer hotspot.
oncokb
PM2 Met Met (supporting): gnomAD v4.1 allele frequency 0.01618% is below the 0.1% PM2 cutoff.
gnomad_v4 gnomad_v2 gnomad_canada PMID:32074614
PM3 N/A Not applicable: PTCH1-related Gorlin syndrome is autosomal dominant, so recessive trans-allele evidence does not apply.
PMID:32074614
PM4 N/A Not applicable: this missense change does not alter protein length, so PM4's in-frame indel/stop-loss premise does not apply.
pvs1_generic_framework generic_acmg_combination_rules
PM5 Not met Not met: no confirmed pathogenic missense change at residue 108 is available as a comparator.
PMID:32074614
PM6 Not assessed Not assessed: no de novo occurrence with incomplete parental testing is reported.
PMID:32074614
PP1 Not assessed Not assessed: no family segregation data are reported for this variant.
PMID:32074614
PP2 Not assessed Not assessed: no quantitative evidence shows PTCH1 has a low rate of benign missense variation.
PP3 Not met Not met: REVEL score 0.603 falls in the gray zone between the >0.750 PP3 and <0.250 BP4 thresholds.
revel spliceai generic_acmg_combination_rules PMID:32074614
PP4 Not assessed Not assessed: the reported proband had isolated Kallmann syndrome without Gorlin-Goltz features.
PMID:32074614
PP5 Not assessed Not assessed: no ClinVar expert-panel pathogenic classification exists for this variant.
clinvar
BA1 Not met Not met: highest population allele frequency 0.04484% is far below the 1% BA1 threshold.
gnomad_v4 gnomad_v2 gnomad_canada
BS1 Not met Not met: highest observed allele frequency 0.04484% is below the 0.3% BS1 threshold.
gnomad_v4 gnomad_v2 gnomad_canada
BS2 Met Met (supporting): one homozygous carrier in gnomAD v4.1 is inconsistent with a highly penetrant dominant PTCH1 disorder.
gnomad_v4 PMID:32074614
BS3 Not assessed Not assessed: no validated functional assay demonstrating a benign effect was available.
oncokb PMID:32074614
BS4 Not assessed Not assessed: inheritance from an unaffected mother does not formally establish lack of segregation with a PTCH1-related phenotype.
PMID:32074614
BP1 Not assessed Not assessed: no framework establishes that disease-causing PTCH1 variants are primarily truncating.
PMID:32074614
BP2 Not assessed Not assessed: no co-occurring second PTCH1 variant is reported; an unaffected parent alone does not qualify.
PMID:32074614
BP3 N/A Not applicable: BP3 concerns in-frame indels in repetitive regions; this missense change does not qualify.
pvs1_generic_framework generic_acmg_combination_rules
BP4 Not met Not met: REVEL score 0.603 is above the <0.250 BP4 threshold and in the calibrated gray zone.
revel spliceai generic_acmg_combination_rules
BP5 Not assessed Not assessed: no independent molecular diagnosis fully explaining the phenotype is identified.
BP6 Not assessed Not assessed: no ClinVar expert-panel benign classification exists for this variant.
clinvar
BP7 N/A Not applicable: BP7 applies only to synonymous variants; this missense change is outside its scope.
generic_acmg_combination_rules
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