About PTEN
No gene-level summary was recorded for this case.
No variant summary was recorded for this case.
Five-step scale from benign to pathogenic. This variant is pathogenic. Select a step to read what it means.
Pathogenic.A pathogenic classification under the recorded framework.
Gene-level background from the recorded interpretation.
Words with a dotted underline have a short definition. Hover or tap them.No gene-level summary was recorded for this case.
The recorded framework is ClinGen PTEN VCEP v3.2.0. The criteria and strengths shown below come from the saved assessment; this page does not recalculate the classification.
The applied criteria and their strengths are shown as assessed under the stated framework.
Canonical +1 splice donor variant (c.253+1G>A) in PTEN intron 4. Per the PTEN VCEP decision tree (NM_000314.8), canonical GT-AG ±1,2 splice site disruptions at or 5' to p.D375 (c.1121) are assigned PVS1. This variant is far 5' of p.D375, and exon 4 skipping with frameshift p.(Ala72Thrfs*5) and predicted NMD was confirmed by RT-PCR in patient-derived lymphoblastoid cells.
A different nucleotide change at the same position, c.253+1G>T, has been established as pathogenic in family N4 with complete cosegregation with Cowden disease. SpliceAI predicts a donor loss delta score of 0.99 for c.253+1G>A, consistent with impact equal to the known pathogenic c.253+1G>T variant, satisfying the PTEN VCEP PS1 rule for same-nucleotide-position splice variants.
PMID:28677221 (Chen et al. 2017) characterized c.253+1G>A in patient-derived lymphoblastoid cells by RT-PCR, demonstrating exon 4 skipping resulting in frameshift p.(Ala72Thrfs*5). PTEN protein expression was significantly decreased (~50% reduction) and downstream P-AKT was significantly increased in the splice-altered group, satisfying the PTEN VCEP PS3 Strong rule for RNA or other assay demonstrating impact on splicing.
c.253+1G>A is absent from gnomAD v2.1, gnomAD v4.1, and gnomAD-Canada v1.0, satisfying the PTEN VCEP PM2_Supporting threshold of allele frequency <0.00001 (0.001%).
No benign criterion marked as applied in the recorded assessment.
Richards et.al., 2015 - Combining rules v3.2.0 criteria-combination framework: matched Rule1 (1 Pathogenic.Very Strong + Pathogenic.Strong >=1) with applied criteria: PVS1 very strong, PS1 strong, PS3 strong, PM2 supporting; maps to Pathogenic.
Evidence summaries and captured source records, where available. Missing entries should not be interpreted as negative findings.
gnomAD v4.1 allele counts were not recorded for this variant.
Absent from gnomAD v2.1.
Absent from gnomAD-Canada v1.0.
Recorded SpliceAI maximum delta score: 0.990. Refer to the recorded PP3/BP4 rationale for interpretation.
7 Pathogenic.
No standalone functional evidence summary is recorded in evidence_summary.functional.
This variant has previously been reported in somatic cancers (COSMIC; COSV64289910, n = 8 times).
ACMG/AMP criteria under ClinGen PTEN VCEP v3.2.0, with the data and sources behind each one.
26 criteria with recorded statuses: 4 met · 8 not met · 6 not assessed · 8 not applicable. Open any row for the full reasoning, the rule and the evidence behind it.
c.253+1G>A is a canonical +1 splice donor variant in PTEN intron 4. Per the PTEN VCEP PVS1 decision tree, canonical GT-AG splice site disruptions at or 5' to p.D375 (c.1121) qualify for PVS1 at very strong strength.
Functional characterization in patient-derived lymphoblastoid cells (PMID:28677221) demonstrated that c.253+1G>A causes exon 4 skipping, resulting in a frameshift (p.Ala72Thrfs*5) with predicted NMD. PTEN protein expression was significantly decreased and P-AKT was significantly increased, satisfying PS3 at strong strength per PTEN VCEP specifications.
A different nucleotide substitution at the same position, c.253+1G>T, has been established as pathogenic with complete cosegregation with Cowden disease in family N4 (PMID:9259288). SpliceAI predicts a donor loss delta of 0.99 for c.253+1G>A, indicating impact equal to the known pathogenic variant, satisfying PS1 at strong strength.
c.253+1G>A is absent from gnomAD v2.1, v4.1, and gnomAD-Canada, satisfying PM2 at supporting strength (allele frequency <0.001% per PTEN VCEP).
This variant has been reported in ClinVar as Pathogenic by 7 clinical laboratories (ClinVar Variation ID: 7820) and has been observed in somatic cancers (COSMIC, n=8).
Combined classification: PVS1 (very_strong) + PS1 (strong) + PS3 (strong) + PM2 (supporting). Under the ACMG/AMP 2015 combining rules per the PTEN VCEP framework, Rule 1 is satisfied: one very strong criterion (PVS1) plus at least one strong criterion (PS1, PS3) → Pathogenic.
No criteria match.
No further detail was recorded.
No further detail was recorded.
No further detail was recorded.
Every interpreted variant in PTEN, mapped onto the exon structure of NM_000314.6. Select a row to find it on the plot.
| Protein | Location | Classification | Link |
|---|
Absent from gnomAD v4.1.
Absent from gnomAD v2.1.
Absent from gnomAD-Canada v1.0.
SpliceAI predicts possible splice impact for this variant (max delta score = 0.99). BayesDel score = 0.317417.
9 paper records listed. 2 cited in the classification.
c.253+1G>A 4 Exon 4 skipping p. (Ala72Thrfs * 5) 1
Location Table 1; Results, paragraph describing exon 4 splice mutations
Context RT-PCR from patient-derived lymphoblastoid cell lines, Western blot for PTEN/P-AKT/P-ERK1/2 protein expression
In family N4 the first nucleotide of intron 4 was changed from G into T causing a mutation in the nearly invariant splice site sequence GU to UU.
Location Table 1, family N4 entry; Results, splice site mutation paragraph
Context Genomic DNA sequencing from lymphocyte DNA of CD patients
139 253+1G>A Numerous
Patient data table (mutation list with polyp counts)
three (10%) were splice site mutations
Table 1; Results section
Screenshots represent source records captured during evidence collection. Select one to view the recorded source content.
The evidence statements recorded by the interpretation pipeline. They have not been reinterpreted by the page.
Absent from gnomAD v4.1.
Absent from gnomAD v2.1.
Absent from gnomAD-Canada v1.0.
This variant has been reported in ClinVar as Pathogenic (7 clinical laboratories). (ClinVarID = 7820)
SpliceAI predicts possible splice impact for this variant (max delta score = 0.99). BayesDel score = 0.317417.
This variant has previously been reported in somatic cancers (COSMIC; COSV64289910, n = 8 times).