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Variant interpretation report

EZH2 c.1936T>A, p.Tyr646Asn

NM_004456.5:c.1936T>A NP_004447.2:p.(Tyr646Asn) Missense · exon 16 View identifiers
Classification
Likely pathogenic

Variant description:

The EZH2 NM_004456.5:c.1936T>A (NP_004447.2:p.(Tyr646Asn)) missense variant could not be checked in COSMIC, and lies in a statistically significant hotspot (cancerhotspots.org). Experimental evidence: Recombinant PRC2 Y641N showed 9.01 versus 4.90 units/ng/min on dimethylated H3K27, with altered H3K27me3 in heterozygous cells. Based on available guidelines, this variant is considered to be Likely Pathogenic.

Five-step scale from benign to pathogenic. This variant is likely pathogenic. Select a step to read what it means.

Likely pathogenic.A likely pathogenic classification under the recorded framework.

In plain language

Gene-level background from the recorded interpretation.

About EZH2

EZH2 encodes the catalytic component of the Polycomb repressive complex 2 (PRC2), which helps control gene activity by adding methyl groups to histone H3 and repressing developmental genes. Abnormal EZH2 activity is associated with blood disorders, including follicular and diffuse large B-cell lymphomas, myelodysplastic syndromes, and myeloproliferative neoplasms. In cancer, EZH2 can act either as an oncogene or as a tumor suppressor, depending on the cancer type.

LYFE Sciences is an AI system, and it can make mistakes. Criteria may be applied incorrectly, sources may be misread, and a confident-looking classification can still be wrong. Double-check every criterion and its underlying evidence before relying on any call.
01The reasoning

How it was classified

The recorded framework is Generic ACMG/AMP 2015 with ClinGen SVI recommendations. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.

Recorded applied criteria

The applied criteria and their strengths are shown as assessed under the stated framework.

Pathogenic evidence criteria: 4 Benign evidence criteria: 0
Pathogenic criteria applied · 4
PS3Strong
PS3 · strong

Met (strong): recombinant PRC2 Y641N showed 9.01 versus 4.90 units/ng/min on dimethylated H3K27, with altered H3K27me3 in heterozygous cells.

PM1Moderate
PM1 · moderate

Met at moderate strength: Tyr646 is a statistically significant recurrent EZH2 hotspot with documented altered PRC2 activity and the variant is absent from gnomAD v2.1 and v4.1.

PM2Supporting
PM2 · supporting

Met at supporting strength: the variant is absent from gnomAD v2.1 and v4.1, meeting the PM2 supporting threshold of <=0.0001.

PP3Moderate
PP3 · moderate

Met at moderate strength: REVEL 0.895 meets the generic PP3 moderate threshold of >=0.773 for this missense variant.

Benign criteria applied · 0

No benign criterion marked as applied in the recorded assessment.

Recorded classification: Likely pathogenic

Likely Pathogenic: PS3 strong plus PM1 and PP3 moderate satisfy the generic ACMG/AMP combination rule, with PM2 supporting additional evidence.

02The sources

Evidence at a glance

Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.

No screenshot for this evidence
REVEL score
0.895 recorded score

Recorded REVEL score: 0.895. Refer to the recorded PP3/BP4 rationale for interpretation.

ClinVar submissions
Not recorded

A ClinVar laboratory submission summary was not recorded. ClinVar API review status: criteria provided, single submitter.

Context only ClinVar ↗
Functional evidence
Statement recorded

OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Likely Gain-of-function; curated oncogenicity label: Likely Oncogenic.

Somatic evidence
Not assessed

No COSMIC evidence statement is recorded in this case.

Cancer Hotspots

This variant lies in a statistically significant hotspot.

Context only Cancer Hotspots ↗
For specialists

Technical detail

ACMG/AMP criteria under Generic ACMG/AMP 2015 with ClinGen SVI recommendations, with the data and sources behind each one.

28 criteria with recorded statuses: 4 met · 7 not met · 12 not assessed · 5 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.

Met Not met Not assessed Not applicable

Under generic ACMG/AMP rules, PM1 is supported at moderate strength by the EZH2 Tyr641/Y646 hotspot and functional catalytic-region evidence.

PS1 and PM5 are not assessed because the available same-residue evidence is somatic/functional and does not establish the required prior pathogenic comparator under generic ACMG/AMP criteria.

PP2 is not assessed because the required gene-level benign missense rate and validated missense-mechanism evidence are unavailable.

BP1 is not met because the available EZH2 disease context supports a missense-associated dominant-negative mechanism rather than a primarily truncating mechanism.

PS2, PM6, PP1, and BS4 are not assessed because the available evidence contains no qualifying germline proband-parent data, affected-relative segregation data, or affected-relative negative testing; available variant-specific publications are somatic oncology studies.

No VCEP covers EZH2 in this case; the supplied generic ACMG/AMP 2015 definitions govern.

PS4 was not assessed because no verified case-control counts or qualifying OR/RR with confidence interval were available.

PP4 and BP5 were not assessed because the required patient-level phenotype/family-history or alternate-molecular-basis evidence was absent.

PP5 and BP6 were not met because the exact ClinVar record has a single-submitter Oncogenic classification and no expert-panel Pathogenic/Likely pathogenic, Benign, or Likely benign classification.

The variant is missense, so PP3 and BP4 use the REVEL path only; REVEL 0.895 meets PP3 moderate but not BP4 supporting.

Met · 4

PS3 StrongACMG_2015Met (strong): recombinant PRC2 Y641N showed 9.01 versus 4.90 units/ng/min on dimethylated H3K27, with altered H3K27me3 in heterozygous cells. Details ▾Hide ▴
Reasoning

PS3 is met at strong strength. The variant NM_004456.5:c.1936T>A, p.(Tyr646Asn), is described in the functional literature as EZH2 Y641N under an alternate five-residue numbering convention. Independent functional studies used appropriate wild-type comparators and multiple biologically relevant systems. In recombinant PRC2 methyltransferase assays, Y641N had markedly altered substrate specificity: specific activity on dimethylated H3K27 was 9.01 units/ng/min versus 4.90 for wild-type EZH2, while activity on unmethylated and monomethylated substrates was reduced. Heterozygous lymphoma cell lines and tumor samples showed increased H3K27me3, and a conditional mouse model expressing Ezh2 Y641N showed increased germinal-center formation and approximately threefold increased H3K27me3, with the phenotype eliminated by EZH2 inhibition. These concordant biochemical, cellular, tumor, and in vivo results demonstrate a reproducible alteration of EZH2/PRC2 function supportive of a damaging gain-of-function effect. This satisfies the ACMG/AMP PS3 definition, although the available evidence is not a clinical diagnostic-laboratory validation study warranting escalation beyond the strong code.

Rule
Well-established in vitro or in vivo functional studies supportive of a damaging effect on the gene or gene product.
Evidence considered
  • Yap et al. 2011 (PMID:21190999) directly studied EZH2 Y641N, corresponding to p.(Tyr646Asn) under the case transcript numbering, using recombinant PRC2 complexes containing wild-type or mutant EZH2 and unmethylated, monomethylated, and dimethylated H3K27 peptides.
  • Yap et al. 2011 Table 1 reported Y641N specific activities of 0.40, 0.59, and 9.01 units/ng/min on unmethylated, monomethylated, and dimethylated H3K27, respectively, versus 10.28, 9.55, and 4.90 for wild-type EZH2; the study also assessed heterozygous lymphoma cell lines and primary tumor samples.
  • Sneeringer et al. 2010 (PMID:21078963) independently used recombinant five-component PRC2 methyltransferase assays, nucleosomes, kinetic analysis, and heterozygous Y641N lymphoma cell lines, finding enhanced activity on H3K27me2 and increased H3K27me3 with reduced H3K27me2 in cells.
  • Béguelin et al. 2013 (PMID:23680150) used a conditional Ezh2 Y641N mouse model in germinal-center B cells, reporting increased germinal-center hyperplasia and approximately threefold increased H3K27me3; EZH2 inhibition eliminated the Y641N-associated phenotype.
  • The applied ACMG/AMP rule is the PS3 definition requiring well-established in vitro or in vivo functional studies supportive of a damaging effect on the gene or gene product.
Sources
PM1 ModerateACMG_2015Met at moderate strength: Tyr646 is a statistically significant recurrent EZH2 hotspot with documented altered PRC2 activity and the variant is absent from gnomAD v2.1 and v4.1. Details ▾Hide ▴
Reasoning

NP_004447.2:p.(Tyr646Asn) lies at the recurrent EZH2 Tyr641/Y646 hotspot in the catalytic SET-domain region. PMID:21078963 and PMID:21190999 document recurrent substitutions at this residue and altered PRC2 methyltransferase activity, while the Cancer Hotspots result identifies EZH2 Y646 as a statistically significant hotspot. The available population data show the queried variant absent from gnomAD v2.1 and v4.1; no benign variation evidence for this hotspot was identified. Under generic ACMG/AMP, this supports PM1 at moderate strength.

Rule
Located in a mutational hot spot and/or critical and well-established functional domain (e.g. active site of an enzyme) without benign variation.
Evidence considered
  • Cancer Hotspots query EZH2 Y646 returned a statistically significant hotspot; the extracted result is flagged for human confirmation because the row was only partially parsed.
  • PMID:21078963 reports recurrent EZH2 Tyr641 substitutions and shows altered methyltransferase kinetics for Y641N-containing PRC2.
  • PMID:21190999 reports recurrent Y641 mutations and markedly altered substrate preference and H3K27 trimethylation for Y641N-containing PRC2.
  • gnomAD v2.1 and gnomAD v4.1 both report the queried variant absent.
Still missing
  • The Cancer Hotspots extraction is flagged as partially parsed, so the hotspot display should be confirmed by a human reviewer.
Sources
PM2 SupportingACMG_2015Met at supporting strength: the variant is absent from gnomAD v2.1 and v4.1, meeting the PM2 supporting threshold of <=0.0001. Details ▾Hide ▴
Reasoning

PM2 is met at supporting strength. NM_004456.5:c.1936T>A (EZH2 p.Tyr646Asn) is absent from gnomAD v2.1 and gnomAD v4.1, and the evidence record also reports absence from GNOMAD_V2_1_NON_CANCER and GNOMAD_V3_1_NON_CANCER. Thus the variant is absent from the available population controls, satisfying the generic PM2 supporting threshold of <=0.0001; no ancestry-specific or cohort-specific frequency is available to weaken this conclusion.

Rule
Absent from controls (or at extremely low frequency if recessive) in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium.
Evidence considered
  • gnomAD v2.1 reports the variant absent.
  • gnomAD v4.1 reports the variant absent.
  • The evidence record also reports absence from GNOMAD_V2_1_NON_CANCER and GNOMAD_V3_1_NON_CANCER; the reported v2 non-cancer subset is exomes-only and the v3 non-cancer subset is genomes-only, but both are absent for this variant.
  • The generic PM2 supporting threshold is <=0.0001, supplied in the case calibration block as the ClinGen SVI recommendation to downgrade PM2 to Supporting (PMID:25741868).
Sources
PP3 ModerateACMGMet at moderate strength: REVEL 0.895 meets the generic PP3 moderate threshold of >=0.773 for this missense variant. Details ▾Hide ▴
Reasoning

NM_004456.5:c.1936T>A is a missense variant, NP_004447.2:p.(Tyr646Asn), so the applicable generic computational path is REVEL only. The REVEL score is 0.895, meeting the supplied PP3 moderate threshold of >= 0.773 from the ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997). SpliceAI is not used for PP3 because splice prediction is not the governing path for this missense variant; BayesDel is not available for generic PP3/BP4 strength assignment because no generic ACMG-strength calibration is established.

Rule
Multiple lines of computational evidence support a deleterious effect on the gene or gene product (conservation, evolutionary, splicing impact, etc.). ... Missense variant -> REVEL only. Its SpliceAI score says nothing about whether the amino-acid substitution is tolerated, so 'no predicted splice impact' is never BP4 support for a missense variant. ... PP3 (moderate): >= 0.773 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Local REVEL predictor lookup for NM_004456.5:c.1936T>A / NP_004447.2:p.(Tyr646Asn): REVEL = 0.895.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997) supplies the generic PP3 moderate cutoff of >= 0.773; 0.895 meets it.
  • SpliceAI max delta = 0.006 was not counted because the governing generic path for a missense variant is REVEL only.
  • BayesDel score = 0.50006 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel

Not met · 7 · evaluated, threshold not reached

PP5 ACMG_2015Not met: ClinVar has one single-submitter Oncogenic record and no exact-variant expert-panel Pathogenic or Likely pathogenic classification. Details ▾Hide ▴
Reasoning

PP5 requires a reputable source to recently report the variant as pathogenic when the underlying evidence is unavailable for independent evaluation. The exact ClinVar record is classified Oncogenic with one single-submitter, criteria-provided submission and no expert-panel submission; the available record is not an exact-variant ClinVar expert-panel Pathogenic or Likely pathogenic classification. OncoKB reports Likely Oncogenic, not the required expert-panel ClinVar classification. PP5 is not met.

Rule
Reputable source recently reports variant as pathogenic, but the evidence is not available to the laboratory to perform an independent evaluation.
Evidence considered
  • ClinVar variation 376217 exactly matches NM_004456.5:c.1936T>A (p.Tyr646Asn), but reports one single-submitter Oncogenic submission, criteria provided, with no expert-panel submission.
  • OncoKB labels EZH2 Y646N Likely Oncogenic, but this is not an exact-variant ClinVar expert-panel Pathogenic or Likely pathogenic classification.
Sources
BA1 ACMG_2015Not met: the variant is absent from gnomAD v2.1 and v4.1, providing no allele frequency at or above the 0.05 BA1 threshold. Details ▾Hide ▴
Reasoning

BA1 is not met. NM_004456.5:c.1936T>A (EZH2 p.Tyr646Asn) is absent from gnomAD v2.1 and gnomAD v4.1, including the reported non-cancer subsets, so no filtering allele frequency or grpmax FAF is available and the >=0.05 stand-alone benign threshold is not reached. The available ClinVar record is a single-submitter somatic oncogenic classification for neoplasm, not a germline population-frequency exception that would override the observed absence.

Rule
Allele frequency is above 5% in Exome Sequencing Project, 1000 Genomes or Exome Aggregation Consortium.
Evidence considered
  • gnomAD v2.1 reports the variant absent; no allele count, allele frequency, popmax point estimate, or grpmax FAF is available.
  • gnomAD v4.1 reports the variant absent; no allele count, allele frequency, popmax point estimate, or grpmax FAF is available.
  • The evidence record also reports absence from GNOMAD_V2_1_NON_CANCER and GNOMAD_V3_1_NON_CANCER; no non-cancer frequency is available.
  • The generic BA1 default is >=0.05, supplied in the case calibration block and attributed there to ACMG/AMP 2015 (PMID:25741868).
  • ClinVar variation 376217 is classified Oncogenic by one submitter for a somatic neoplasm with one-star criteria-provided review status; this is not a germline pathogenic consensus.
Sources
BS1 ACMG_2015Not met: gnomAD v2.1 and v4.1 report absence, so the filtering allele frequency cannot exceed the generic BS1 default of 0.01. Details ▾Hide ▴
Reasoning

BS1 is not met. The variant is absent from gnomAD v2.1 and gnomAD v4.1, and is also reported absent from the available non-cancer subsets, so the filtering allele frequency (grpmax FAF) is not elevated and cannot exceed the generic 0.01 default. No maximum-credible-frequency calculation is needed because there is no observed population frequency to evaluate; the available data do not support a benign frequency signal.

Rule
Allele frequency is greater than expected for the disorder.
Evidence considered
  • gnomAD v2.1 and v4.1 report the variant absent, with no allele count, allele frequency, popmax point estimate, or grpmax FAF.
  • The evidence record also reports absence from GNOMAD_V2_1_NON_CANCER and GNOMAD_V3_1_NON_CANCER; no source-specific elevated frequency is available.
  • The generic BS1 default is >=0.01, supplied in the case calibration block; the prompt requires consideration of prevalence, penetrance, allelic heterogeneity, and maximum credible allele frequency before applying it.
  • Because no observed frequency exists, there is no ancestry-specific frequency or reduced-penetrance founder signal requiring a maximum-credible-frequency calculation.
Sources
BS3 ACMG_2015Not met: Y641N PRC2 activity increased to 9.01 versus 4.90 units/ng/min on dimethylated H3K27, contradicting a no-damaging-effect result. Details ▾Hide ▴
Reasoning

BS3 is not met because the available functional studies do not show no damaging effect on protein function or splicing; instead, they show a reproducible altered EZH2/PRC2 function. The same variant, described as EZH2 Y641N under an alternate numbering convention, displayed increased activity on dimethylated H3K27 in recombinant PRC2 assays, increased H3K27me3 in heterozygous lymphoma cells and tumors, and a gain-of-function phenotype in a conditional mouse model. No benign functional result or validated assay demonstrating preserved protein function or normal splicing was identified. Therefore BS3 is contradicted by the functional evidence rather than merely left unassessed.

Rule
Well-established in vitro or in vivo functional studies show no damaging effect on protein function or splicing.
Evidence considered
  • Yap et al. 2011 (PMID:21190999) found altered substrate specificity for EZH2 Y641N, including 9.01 units/ng/min activity on dimethylated H3K27 versus 4.90 for wild-type EZH2, together with increased H3K27me3 in heterozygous lymphoma models.
  • Sneeringer et al. 2010 (PMID:21078963) independently found altered PRC2 catalytic activity and increased H3K27me3 associated with Y641N.
  • Béguelin et al. 2013 (PMID:23680150) reported an Ezh2 Y641N-dependent germinal-center phenotype and increased H3K27me3 in vivo, which was eliminated by EZH2 inhibition.
  • The applied ACMG/AMP rule defines BS3 as well-established in vitro or in vivo functional studies showing no damaging effect on protein function or splicing; the cited studies instead demonstrate altered function.
Sources
BP1 ACMG_2015Not met: EZH2 disease context emphasizes heterozygous missense variants and reports no early truncating mutations as the primary mechanism. Details ▾Hide ▴
Reasoning

BP1 requires a gene for which primarily truncating variants are known to cause disease. The available EZH2 germline context instead describes Weaver syndrome as associated with heterozygous missense variants and notes a lack of early truncating mutations, with a proposed dominant-negative mechanism. That evidence does not support a primarily truncating disease mechanism, so BP1 is not met.

Rule
Missense variant in a gene for which primarily truncating variants are known to cause disease.
Evidence considered
  • The EZH2 germline context reports Weaver syndrome-associated heterozygous missense variants and states that the lack of early truncating mutations led to a dominant-negative mechanism hypothesis.
Sources
pvs1_gene_context
BP4 ACMGNot met: REVEL 0.895 exceeds the generic BP4 supporting threshold of <=0.29 for this missense variant. Details ▾Hide ▴
Reasoning

NM_004456.5:c.1936T>A is a missense variant, so BP4 must be judged by REVEL only. REVEL is 0.895, which does not meet the supplied BP4 supporting threshold of <= 0.29 from the ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997). The SpliceAI max delta of 0.006 cannot substitute for the missense REVEL path, and the BayesDel score is not usable because no generic ACMG-strength calibration is established.

Rule
Multiple lines of computational evidence suggest no impact on gene or gene product (conservation, evolutionary, splicing impact, etc). ... Missense variant -> REVEL only. Its SpliceAI score says nothing about whether the amino-acid substitution is tolerated, so 'no predicted splice impact' is never BP4 support for a missense variant. ... BP4 (supporting): <= 0.29 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Local REVEL predictor lookup for NM_004456.5:c.1936T>A / NP_004447.2:p.(Tyr646Asn): REVEL = 0.895.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997) supplies the generic BP4 supporting cutoff of <= 0.29; 0.895 does not meet it.
  • SpliceAI max delta = 0.006 was not counted because the governing generic path for a missense variant is REVEL only.
  • BayesDel score = 0.50006 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
BP6 ACMG_2015Not met: no exact-variant ClinVar expert-panel Benign or Likely benign classification is present; the available submission is single-submitter Oncogenic. Details ▾Hide ▴
Reasoning

BP6 requires a reputable source to recently report the variant as benign when the underlying evidence is unavailable for independent evaluation. The exact ClinVar record is classified Oncogenic with one single-submitter, criteria-provided submission and no expert-panel submission; no exact-variant ClinVar expert-panel Benign or Likely benign classification is present. BP6 is not met.

Rule
Reputable source recently reports variant as benign, but the evidence is not available to the laboratory to perform an independent evaluation.
Evidence considered
  • ClinVar variation 376217 exactly matches NM_004456.5:c.1936T>A (p.Tyr646Asn), but has one single-submitter Oncogenic submission and no expert-panel submission; therefore it cannot support BP6.
Sources

Not assessed · 12 · no assessment recorded

PS1 ACMG_2015Not assessed: the same Tyr-to-Asn substitution is reported, but no established pathogenic comparator under generic germline ACMG/AMP criteria is available. Details ▾Hide ▴
Reasoning

The variant is NP_004447.2:p.(Tyr646Asn), also reported as EZH2 Y641N under an alternate five-residue numbering convention in PMID:21078963, PMID:21190999, and PMID:23680150. These papers provide functional and somatic lymphoma evidence for the same amino-acid substitution, but the available evidence does not establish a previously established pathogenic variant under generic germline ACMG/AMP criteria; ClinVar is a single-submitter somatic Oncogenic record without an expert-panel or usable criterion-lead submission. Therefore PS1 cannot be adjudicated as met from the available evidence.

Rule
Same amino acid change as a previously established pathogenic variant regardless of nucleotide change. ... Caveat: Beware of changes that impact splicing rather than at the amino acid/protein level.
Evidence considered
  • PMID:21078963 reports EZH2 Y641N, corresponding to NP_004447.2:p.(Tyr646Asn) under the alternate numbering convention, and directly studies its biochemical effects.
  • PMID:21190999 reports EZH2 Y641N in lymphoma cell lines and tumors and characterizes altered PRC2 substrate specificity.
  • PMID:23680150 describes Ezh2Y641N in a conditional mouse model and reports increased H3K27me3 and germinal-center hyperplasia.
  • ClinVar variation 376217 is a single-submitter somatic Oncogenic record with no expert-panel submission and no usable criterion-lead submission.
Still missing
  • A validated prior pathogenic classification for the same amino-acid change, preferably from an expert-reviewed germline source, is not available.
Sources
PS2 ACMG_2015Not assessed: no proband-level de novo observation with confirmed maternity and paternity is documented for NM_004456.5:c.1936T>A. Details ▾Hide ▴
Reasoning

PS2 cannot be assessed because the available evidence does not document a proband with the relevant germline disease, absence of family history, or de novo status established by confirmation of both maternity and paternity. The available literature concerns somatic EZH2 mutations in lymphoma and does not provide qualifying parental testing for this variant.

Rule
De novo (both maternity and paternity confirmed) in a patient with the disease and no family history.
Evidence considered
  • No proband-level germline case with parental testing, confirmed maternity and paternity, and documented absence of family history is available.
  • The available variant-specific publications describe somatic EZH2 mutations in lymphoma rather than qualifying germline de novo observations.
Still missing
  • A documented patient with the relevant germline disease is needed.
  • Maternal and paternal identity must both be confirmed for the proband.
  • The family history must be documented as negative for the relevant disease.
PS4 ACMG_2015Not assessed: no verified affected-versus-control counts, odds ratio/relative risk, or 95% confidence interval were reported for EZH2 p.Tyr646Asn. Details ▾Hide ▴
Reasoning

The governing PS4 rule requires a case-control prevalence comparison with RR or OR >5.0 and a confidence interval that does not include 1.0. The reviewed variant-specific literature reports EZH2 Y641N/Y646N in lymphoma cell lines, tumors, and experimental models, but does not provide affected-case and unaffected/population-control counts or a case-control OR/RR and confidence interval. The literature_pass PS4 index points to PMID:34131312, but that paper is a general chromosomal microarray technical standard, is not available in the case full-text map, and its available title/metadata do not verify variant-specific case-control evidence. Therefore PS4 cannot be assessed from the available evidence.

Rule
The prevalence of the variant in affected individuals is significantly increased compared to the prevalence in controls. ... Note 1: Relative risk (RR) or odds ratio (OR), as obtained from case-control studies, is >5.0 and the confidence interval around the estimate of RR or OR does not include 1.0.
Evidence considered
  • Yap et al. 2011 (PMID:21190999) reports EZH2 Y641N in follicular lymphoma and germinal-center B-cell diffuse large B-cell lymphoma samples and cell lines, but supplies no unaffected/population control comparison or OR/RR with confidence interval for this variant.
  • Morin et al. 2010 (PMID:20081860) reports recurrent EZH2 Y641 mutations in follicular lymphoma and germinal-center B-cell-like DLBCL cohorts, but does not explicitly identify c.1936T>A/p.Y646N and does not provide the required variant-specific case-control comparison.
  • The literature_pass criteria index lists PMID:34131312 for PS4, but the available record identifies it as a general ACMG chromosomal microarray technical standard and provides no verified variant-specific case-control data.
Still missing
  • A verified case-control study or equivalent affected-case and matched-control counts for EZH2 p.Tyr646Asn are needed.
  • The reported PS4 lead PMID:34131312 requires direct abstract or full-text verification if it is intended to support PS4.
Sources
PM5 ACMG_2015Not assessed: alternate missense substitutions occur at Tyr646, but none is established as pathogenic under the generic ACMG/AMP evidence available here. Details ▾Hide ▴
Reasoning

The evidence identifies other EZH2 substitutions at the same Tyr641/Y646 residue, including Y641F, Y641S, and Y641H in PMID:21078963, and recurrent Y641 mutations in PMID:20081860 and PMID:21190999. However, the available records do not establish one of those alternate missense variants as a pathogenic variant under generic ACMG/AMP criteria; they are primarily somatic lymphoma and functional studies, and the ClinVar record for the queried variant is not an expert-reviewed germline classification. The same-residue comparator evidence therefore cannot be safely converted to PM5.

Rule
Novel missense change at an amino acid residue where a different missense change determined to be pathogenic has been seen before. ... Caveat: Beware of changes that impact splicing rather than at the amino acid/protein level.
Evidence considered
  • PMID:21078963 states that somatic EZH2 Tyr641 substitutions include Y641F, Y641N, Y641S, and Y641H and characterizes Y641N functionally.
  • PMID:20081860 reports recurrent somatic Y641 mutations and reduced in-vitro methyltransferase activity for tested mutants, without providing a generic ACMG pathogenic classification.
  • PMID:21190999 reports recurrent somatic Y641 mutations in lymphoma and altered PRC2 activity for Y641N.
  • ClinVar variation 376217 is a single-submitter somatic record and does not provide an expert-reviewed pathogenic comparator classification.
Still missing
  • A validated pathogenic classification for an alternate missense change at Tyr646/Y641 is not available.
Sources
PM6 ACMG_2015Not assessed: no germline de novo observation without confirmed maternity and paternity is documented for NM_004456.5:c.1936T>A. Details ▾Hide ▴
Reasoning

PM6 cannot be assessed because no patient-level germline de novo observation is documented, and there is no evidence that the variant was assumed de novo without confirmation of paternity and maternity. The available literature concerns somatic EZH2 mutations in lymphoma and does not establish PM6.

Rule
Assumed de novo, but without confirmation of paternity and maternity.
Evidence considered
  • No patient-level germline observation and no parental-testing record or de novo assumption is available.
  • The available variant-specific publications describe somatic EZH2 mutations in lymphoma rather than a germline de novo observation.
Still missing
  • A documented patient with the relevant germline disease and the variant is needed.
  • Parental testing or a clear statement that de novo status was assumed without parental confirmation is needed.
PP1 ACMG_2015Not assessed: no affected relatives, informative meioses, or variant co-segregation results are documented for this family. Details ▾Hide ▴
Reasoning

PP1 cannot be assessed because no affected family members carrying the variant, informative meioses, or co-segregation results are documented. Although germline EZH2-related disease is mentioned in the case context, the available variant-specific literature is somatic oncology literature and supplies no family segregation data.

Rule
Co-segregation with disease in multiple affected family members in a gene definitively known to cause the disease.
Evidence considered
  • No affected-relative genotypes, informative meioses, or family co-segregation results are available.
  • The available variant-specific publications do not report familial segregation of NM_004456.5:c.1936T>A.
Still missing
  • Affected relatives with reliable clinical phenotyping must be identified.
  • Variant genotypes for affected relatives and informative meioses are needed.
  • The relevant disease relationship to EZH2 must be established for the segregating family.
PP2 ACMG_2015Not assessed: a validated low benign-missense rate and the required generic gene-level missense-mechanism evidence are not available. Details ▾Hide ▴
Reasoning

The available case evidence describes EZH2 missense disease biology and recurrent somatic missense changes, but it does not provide the gene-level benign missense rate or a governing threshold demonstrating a low rate of benign missense variation. It also does not establish the required generic ACMG/AMP gene-level combination as a validated germline disease mechanism for this criterion. PP2 is therefore not assessed.

Rule
Missense variant in a gene that has a low rate of benign missense variation and where missense variants are a common mechanism of disease.
Evidence considered
  • The available EZH2 papers document recurrent somatic missense mutations and functional effects but do not supply a gene-level benign missense rate for PP2.
  • No generic ACMG/AMP PP2 gene-level assessment or validated threshold is present in the case evidence.
Still missing
  • Gene-level benign missense constraint and validated evidence that missense variants are a common disease mechanism under this criterion are missing.
PP4 ACMG_2015Not assessed: the case materials do not provide a patient phenotype or family history sufficiently specific for a single-genetic-etiology disease. Details ▾Hide ▴
Reasoning

The governing PP4 rule requires a patient's phenotype or family history that is highly specific for a disease with a single genetic etiology. The case evidence identifies EZH2 p.Tyr646Asn and oncology-related literature, but does not provide the patient's phenotype, family history, or a sufficiently specific single-etiology clinical presentation. The criterion therefore cannot be assessed.

Rule
Patient’s phenotype or family history is highly specific for a disease with a single genetic etiology.
Still missing
  • Patient-level phenotype and family-history details are needed to assess specificity for a single genetic etiology.
BS2 ACMG_2015Not assessed: no healthy adult carrying the variant, zygosity, or age-appropriate unaffected status is documented. Details ▾Hide ▴
Reasoning

BS2 is not assessed. The supplied evidence contains population-database absence and a somatic ClinVar record, but no observation of this variant in a healthy adult individual, no zygosity, and no information establishing that an observed individual was unaffected at an age appropriate for a fully penetrant early-onset disorder. Population absence cannot establish BS2.

Rule
Observed in a healthy adult individual for a recessive (homozygous), dominant (heterozygous), or X-linked (hemizygous) disorder, with full penetrance expected at an early age.
Evidence considered
  • gnomAD v2.1 and v4.1 report absence rather than a healthy-carrier observation.
  • The evidence record reports absence from the non-cancer subsets but provides no individual-level carrier, zygosity, phenotype, or age data.
  • ClinVar contains one somatic submission for neoplasm and does not document a healthy adult carrier observation.
  • No source in the supplied evidence establishes full penetrance expected at an early age for the relevant disorder.
Still missing
  • A documented healthy adult observation with zygosity and age/penetrance context is unavailable.
Sources
BS4 ACMG_2015Not assessed: no affected family members with negative variant testing are documented to demonstrate lack of segregation. Details ▾Hide ▴
Reasoning

BS4 cannot be assessed because the available evidence does not identify affected family members who were tested for the variant and found not to carry it. No family structure, phenotype adjudication, or non-segregation results are documented, so lack of segregation cannot be distinguished from absence of family data.

Rule
Lack of segregation in affected members of a family.
Evidence considered
  • No affected family members with negative testing for the variant are documented.
  • No family-based non-segregation analysis or assessment of phenocopies is available.
Still missing
  • Affected family members and their phenotype assessments are needed.
  • Variant testing results for those affected family members are needed.
  • Potential phenocopies and alternative pathogenic variants should be considered if non-segregation is reported.
BP2 ACMG_2015Not assessed: no pathogenic variant in trans or cis, parental or offspring phase testing, or affected-proband allelic observation is documented. Details ▾Hide ▴
Reasoning

BP2 cannot be assessed because the available evidence does not document a pathogenic variant in trans or cis with NM_004456.5:c.1936T>A, does not provide parental or offspring phase testing, and does not report affected-proband allelic observations usable for this criterion. Somatic reports of EZH2 Y641N with a wild-type allele do not establish the required pathogenic-variant phase relationship.

Rule
Observed in trans with a pathogenic variant for a fully penetrant dominant gene/disorder or observed in cis with a pathogenic variant in any inheritance pattern.
Still missing
  • Documented pathogenic-variant pair for this individual
  • Parental or offspring testing establishing cis/trans phase
  • Affected-proband clinical observation with allelic configuration
BP5 ACMG_2015Not assessed: no case documents EZH2 p.Tyr646Asn alongside an independently established alternate molecular basis for disease. Details ▾Hide ▴
Reasoning

The governing BP5 rule requires the variant to be found in a case with an alternate molecular basis for disease. The available case evidence and reviewed papers do not document an individual case carrying EZH2 p.Tyr646Asn together with an independently established alternate molecular cause of that disease. BP5 cannot be assessed.

Rule
Variant found in a case with an alternate molecular basis for disease.
Still missing
  • A case report or cohort record documenting the variant and a confirmed alternate molecular basis is needed.
Not applicable · 5· recorded as not applicable Show reasons ▾Hide reasons ▴
PVS1 N/ANot applicable: PVS1 requires a null variant (nonsense, frameshift, canonical splice, start-loss or stop-loss), and this is a missense variant. Details ▾Hide ▴
Reasoning

PVS1 (ClinGen SVI PVS1 recommendations, PMC6185798, pvs1_generic_framework) applies only to null variant classes — nonsense, frameshift, canonical ±1/2 splice-consensus, translation-initiation-codon loss, and stop-loss variants — each expected to trigger nonsense-mediated decay or otherwise abolish normal protein function. NM_004456.5:c.1936T>A in EZH2 is a missense substitution predicted to produce NP_004447.2:p.(Tyr646Asn). As a result, no null-variant mechanism (nonsense-mediated decay, truncation, or canonical splice disruption) is triggered by this variant class, so PVS1's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PVS1 for EZH2, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_null_variant_class
Evidence considered
  • Deterministic consequence classification: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
PM3 N/ANot applicable: PM3 is restricted to recessive disorders, whereas the available EZH2 context is dominant-negative Weaver syndrome. Details ▾Hide ▴
Reasoning

PM3 is not applicable because its governing definition is restricted to recessive disorders. The available EZH2 disease context is a dominant-negative Weaver syndrome context, and no recessive inheritance context is established for this variant.

Rule
For recessive disorders, detected in trans with a pathogenic variant...This requires testing of parents (or offspring) to determine phase.
Evidence considered
  • The case summary identifies the germline EZH2 disease context as dominant-negative Weaver syndrome; no recessive disorder context is provided.
PM4 N/ANot applicable: PM4 requires a protein-length change, and this is a missense variant. Details ▾Hide ▴
Reasoning

PM4 (Richards et al. 2015, PMID:25741868) applies to protein length changes: in-frame insertions/deletions in a non-repetitive region, or stop-loss variants that extend the protein past the reference stop codon. NM_004456.5:c.1936T>A in EZH2 is a missense substitution predicted to produce NP_004447.2:p.(Tyr646Asn). As a result, no change in protein length occurs, so there is nothing for this criterion to evaluate, so PM4's structural prerequisite is not met by this variant class. No VCEP criteria specification covers PM4 for EZH2, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_stop_loss_or_nonrepeat_indel
Evidence considered
  • Deterministic consequence classification: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
BP3 N/ANot applicable: BP3 requires an in-frame indel in a repeat region, and this is a missense variant. Details ▾Hide ▴
Reasoning

BP3 (Richards et al. 2015, PMID:25741868) applies to in-frame insertions/deletions located in a repetitive region without a known function. NM_004456.5:c.1936T>A in EZH2 is a missense substitution predicted to produce NP_004447.2:p.(Tyr646Asn). As a result, the variant does not alter protein length within a repeat region, so there is nothing for this criterion to evaluate, so BP3's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP3 for EZH2, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_repeat_region_indel
Evidence considered
  • Deterministic consequence classification: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
pvs1_generic_framework ↗generic_acmg_combination_rules
BP7 N/ANot applicable: BP7 requires a synonymous variant, and this is a missense variant. Details ▾Hide ▴
Reasoning

BP7 (Richards et al. 2015, PMID:25741868) is defined for a synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence and the nucleotide is not highly conserved. NM_004456.5:c.1936T>A in EZH2 is a missense substitution predicted to produce NP_004447.2:p.(Tyr646Asn). As a result, the encoded protein sequence is altered, so the criterion's silent-variant premise does not hold regardless of any splicing prediction, so BP7's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP7 for EZH2, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_synonymous
Evidence considered
  • Deterministic consequence classification: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules

Identifiers

Gene
EZH2
Transcript
NM_004456.5
Coding (HGVS c.)
NM_004456.5:c.1936T>A
Protein (HGVS p.)
NP_004447.2:p.(Tyr646Asn)
GRCh38
chr7:148811636 A>T
GRCh37
chr7:148508728 A>T
Location and type
Exon 16 · missense
ClinVar
376217

Gene diagram

Every interpreted variant in EZH2, mapped onto the exon structure of NM_004456.5. Select a row to find it on the plot.

EZH2NM_004456.5
Fetching transcript structure from UCSC…
gnomAD v4.1 Allele count data not recorded
gnomAD v2.1 Allele count data not recorded
gnomAD-Canada v1.0 Allele count data not recorded

Statements

gnomAD v4.1

Absent from gnomAD v4.1.

gnomAD v2.1

Absent from gnomAD v2.1.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat +432 bp
0.006
SpliceAI acceptor gainat +84 bp
0.000
SpliceAI donor lossat +307 bp
0.003
SpliceAI donor gainat -86 bp
0.000
Pangolin splice lossmagnitude shown
-0.002
Pangolin splice gain
0.002

Other predictors

REVEL
0.895
BayesDel
0.500

How the predictions were used

PP3 ModerateACMGMet at moderate strength: REVEL 0.895 meets the generic PP3 moderate threshold of >=0.773 for this missense variant. Details ▾Hide ▴
Reasoning

NM_004456.5:c.1936T>A is a missense variant, NP_004447.2:p.(Tyr646Asn), so the applicable generic computational path is REVEL only. The REVEL score is 0.895, meeting the supplied PP3 moderate threshold of >= 0.773 from the ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997). SpliceAI is not used for PP3 because splice prediction is not the governing path for this missense variant; BayesDel is not available for generic PP3/BP4 strength assignment because no generic ACMG-strength calibration is established.

Rule
Multiple lines of computational evidence support a deleterious effect on the gene or gene product (conservation, evolutionary, splicing impact, etc.). ... Missense variant -> REVEL only. Its SpliceAI score says nothing about whether the amino-acid substitution is tolerated, so 'no predicted splice impact' is never BP4 support for a missense variant. ... PP3 (moderate): >= 0.773 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Local REVEL predictor lookup for NM_004456.5:c.1936T>A / NP_004447.2:p.(Tyr646Asn): REVEL = 0.895.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997) supplies the generic PP3 moderate cutoff of >= 0.773; 0.895 meets it.
  • SpliceAI max delta = 0.006 was not counted because the governing generic path for a missense variant is REVEL only.
  • BayesDel score = 0.50006 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
BP4 ACMGNot met: REVEL 0.895 exceeds the generic BP4 supporting threshold of <=0.29 for this missense variant. Details ▾Hide ▴
Reasoning

NM_004456.5:c.1936T>A is a missense variant, so BP4 must be judged by REVEL only. REVEL is 0.895, which does not meet the supplied BP4 supporting threshold of <= 0.29 from the ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997). The SpliceAI max delta of 0.006 cannot substitute for the missense REVEL path, and the BayesDel score is not usable because no generic ACMG-strength calibration is established.

Rule
Multiple lines of computational evidence suggest no impact on gene or gene product (conservation, evolutionary, splicing impact, etc). ... Missense variant -> REVEL only. Its SpliceAI score says nothing about whether the amino-acid substitution is tolerated, so 'no predicted splice impact' is never BP4 support for a missense variant. ... BP4 (supporting): <= 0.29 — ClinGen SVI REVEL calibration (Pejaver et al. 2022, Am J Hum Genet) (PMID:36413997)
Evidence considered
  • Local REVEL predictor lookup for NM_004456.5:c.1936T>A / NP_004447.2:p.(Tyr646Asn): REVEL = 0.895.
  • ClinGen SVI REVEL calibration (Pejaver et al. 2022, PMID:36413997) supplies the generic BP4 supporting cutoff of <= 0.29; 0.895 does not meet it.
  • SpliceAI max delta = 0.006 was not counted because the governing generic path for a missense variant is REVEL only.
  • BayesDel score = 0.50006 was not used because no generic ACMG-strength calibration is established for BayesDel.
Sources
revel
BP7 N/ANot applicable: BP7 requires a synonymous variant, and this is a missense variant. Details ▾Hide ▴
Reasoning

BP7 (Richards et al. 2015, PMID:25741868) is defined for a synonymous (silent) variant for which splicing prediction algorithms predict no impact to the splice consensus sequence and the nucleotide is not highly conserved. NM_004456.5:c.1936T>A in EZH2 is a missense substitution predicted to produce NP_004447.2:p.(Tyr646Asn). As a result, the encoded protein sequence is altered, so the criterion's silent-variant premise does not hold regardless of any splicing prediction, so BP7's structural prerequisite is not met by this variant class. No VCEP criteria specification covers BP7 for EZH2, so the generic ACMG/AMP 2015 definition applies. This determination was made deterministically from the variant's consequence class, prior to LLM adjudication.

Rule
deterministic_prefilter: requires_synonymous
Evidence considered
  • Deterministic consequence classification: missense (prefetch.json normalized protein consequence)
  • VCEP criterion policy: absent
Sources
generic_acmg_combination_rules

Statement

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.895. BayesDel score = 0.50006.

8 paper records listed. 3 cited in the classification.

Cited in the classification

  • Coordinated activities of wild-type plus mutant EZH2 drive tumor-associated hypertrimethylation of lysine 27 on histone H3 (H3K27) in human B-cell lymphomas.
    Sneeringer CJ et al. · 2010 Dec 7
    The paper explicitly studied EZH2 Y641N, corresponding to the queried EZH2 p.(Y646N) under the stated five-residue numbering offset. It reports recurrent Tyr641 substitutions, including Y641F, Y641N, Y641S, and Y641H, and demonstrates altered methyltransferase kinetics and increased H3K27me3 for Y641N-containing PRC2.
    → PS3 · strong → PM1 · moderate Names this variant
    PMID 21078963 ↗
    Source detail
    Recently, somatic mutations of Tyr641 (Y641F, Y641N, Y641S, and Y641H) of EZH2 were reported to be associated with follicular lymphoma (FL) and the germinal-center B-cell like (GCB) subtype of diffuse large B-cell lymphoma (DLBCL) (1).

    Location Results and Discussion; Table 1; Fig. 3

    Context In vitro methyltransferase assays using recombinant PRC2 complexes containing wild-type or mutant EZH2, with H3K27 peptides and avian nucleosomes; kinetic modeling and analysis of heterozygous EZH2 Y641N lymphoma cell lines.

  • Somatic mutations at EZH2 Y641 act dominantly through a mechanism of selectively altered PRC2 catalytic activity, to increase H3K27 trimethylation.
    Yap DB et al. · 2011 Feb 24
    The paper describes this variant as EZH2 Y641N, matching NP_004447.2:p.(Y646N) with a five-residue numbering offset. It reports recurrent heterozygous somatic Y641 mutations in lymphoma and shows that Y641N-containing PRC2 has altered substrate preference, with markedly enhanced activity on dimethylated H3K27 and increased H3K27me3 in cells and tumors.
    → PS3 · strong → PM1 · moderate Names this variant
    PMID 21190999 ↗
    Source detail
    Strikingly, EZH2Y641 mutants showed (Figure 4) strongly reduced activity on unmethylated or monomethylated peptides but markedly enhanced activity on dimethylated peptides compared with EZH2 wild-type containing PRC2 complexes.

    Location Introduction; Results sections on EZH2Y641 lymphoma cell lines and Y641-containing PRC2 complexes; Table 1

    Context Heterozygous EZH2-mutant lymphoma cell lines and primary DLBCL tumor samples; expression studies and in vitro 3H-SAM methyltransferase assays using recombinant PRC2 complexes and H3K27 peptides.

  • EZH2 is required for germinal center formation and somatic EZH2 mutations promote lymphoid transformation.
    The paper describes the EZH2 Y641N substitution, corresponding to the queried NP_004447.2:p.(Y646N) variant under an alternate protein-numbering convention. In a conditional mouse model expressing Ezh2Y641N in germinal-center B cells, immunization produced germinal-center hyperplasia and an approximately 3-fold increase in H3K27me3; EZH2 inhibition eliminated the associated phenotype.
    → PS3 · strong Names this variant
    PMID 23680150 ↗
    Source detail
    These data demonstrate that Y641 mutation reinforces the GC phenotype-driving function of wild-type EZH2, resulting in an expansion of these proliferative and mutagenic cells.

    Location Results, “Mutant EZH2 Induces Germinal Center Hyperplasia,” Figure 2 and accompanying text

    Context Conditional mouse model expressing Ezh2Y641N in germinal-center B cells; immunization, flow cytometry, splenic immunohistochemistry, H3K27me3 immunoblotting, and EZH2 inhibitor treatment.

Other recorded publications

  • Somatic mutations altering EZH2 (Tyr641) in follicular and diffuse large B-cell lymphomas of germinal-center origin.
    The paper reports recurrent somatic heterozygous mutations at EZH2 SET-domain tyrosine Y641, corresponding to the queried residue under the alternate numbering convention, in follicular lymphoma and germinal-center B-cell-like diffuse large B-cell lymphoma. It reports reduced in-vitro H3K27 trimethylation activity for tested Y641 mutants but does not provide a generic ACMG pathogenic classification.
    Does not name this variant
    PMID 20081860 ↗
    Quoted passage
    The results (Figure 2) indicated that, compared to wild-type EZH2, all four Y641 mutants consistently demonstrated a marked reduction (~7-fold) in their ability to tri-methylate the H3K27 peptide.

    Results, paragraph describing the in vitro EZH2 H3K27 tri-methylation assay; concluding paragraph

  • Frequent mutation of histone-modifying genes in non-Hodgkin lymphoma.
    No paper-specific finding is recorded.
    PMID 21796119 ↗
  • Mutation of A677 in histone methyltransferase EZH2 in human B-cell lymphoma promotes hypertrimethylation of histone H3 on lysine 27 (H3K27).
    McCabe MT et al. · 2012
    No paper-specific finding is recorded.
    PMID 22323599 ↗
  • Standards for the classification of pathogenicity of somatic variants in cancer (oncogenicity): Joint recommendations of Clinical Genome Resource (ClinGen), Cancer Genomics Consortium (CGC), and Variant Interpretation for Cancer Consortium (VICC).
    Horak P et al. · 2022
    No paper-specific finding is recorded.
    PMID 35101336 ↗
  • American College of Medical Genetics and Genomics technical standards and guidelines: microarray analysis for chromosome abnormalities in neoplastic disorders.
    Cooley LD et al. · 2013
    No paper-specific finding is recorded.
    PMID 23619274 ↗

Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.

All source links

Statements for reports

The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.

gnomAD v4.1

Absent from gnomAD v4.1.

gnomAD v2.1

Absent from gnomAD v2.1.

gnomAD-Canada

Not available in gnomAD-Canada v1.0.

ClinVar

This variant has been reported in ClinVar but submission details could not be extracted. (ClinVarID = 376217)

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.01). REVEL score = 0.895. BayesDel score = 0.50006.

Functional

OncoKB identified variant-specific curated literature and context relevant to functional review; biological-effect context: Likely Gain-of-function; curated oncogenicity label: Likely Oncogenic.

Somatic

This variant lies in a statistically significant hotspot.

Cancer Hotspots

This variant lies in a statistically significant hotspot.