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Variant interpretation report

NOTCH2 c.7354C>T, p.(Gln2452Ter)

NM_024408.3:c.7354C>T NP_077719.2:p.(Gln2452Ter) View identifiers
Classification
Uncertain significance

Variant description:

No variant summary was recorded for this case.

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

Uncertain.The recorded classification is uncertain significance.

In plain language

Gene-level background from the recorded interpretation.

About NOTCH2

No gene-level summary was recorded for this case.

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 Not recorded. 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: 2 Benign evidence criteria: 0
Pathogenic criteria applied · 2
PM1Moderate
PM1 · moderate

The variant p.Gln2452Ter truncates the C-terminal portion of the NOTCH2 PEST domain (approx. aa 2418-2472), a well-established functional domain responsible for ubiquitin-mediated protein degradation. PEST domain truncations in NOTCH2 are a characterized pathogenic mechanism causing Hajdu-Cheney syndrome (PMID:21378989) and have been identified in DLBCL (PMID:25314575). Truncation of this degradation domain leads to gain-of-function via increased NOTCH2 protein stability. A well-characterized functional domain in the literature satisfies PM1 for truncating variants that remove or disrupt it.

PM2Moderate
PM2 · moderate

NM_024408.3:c.7354C>T is absent from gnomAD v2.1 and v4.1, meeting the PM2 threshold of allele frequency <0.1% in population databases.

Benign criteria applied · 0

No benign criterion marked as applied in the recorded assessment.

Recorded classification: Uncertain significance

gene-specific framework lacked a usable explicit final combination framework, so generic ACMG/AMP 2015 final-combination rules were applied as fallback; applied criteria: PM1 moderate, PM2 moderate; combination = 2 moderate, which maps to VUS.

02The sources

Evidence at a glance

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

SpliceAI score
0.020 maximum delta

Recorded SpliceAI maximum delta score: 0.020. Refer to the recorded PP3/BP4 rationale for interpretation.

No listed criterion applied SpliceAI ↗
ClinVar submissions
Not recorded

A ClinVar laboratory submission summary was not recorded.

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.

No listed criterion applied OncoKB ↗
COSMIC
Cancer Hotspots
Somatic evidence
No matching record reported

This variant has not previously been reported in somatic cancers (COSMIC).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.

For specialists

Technical detail

ACMG/AMP criteria under Not recorded, with the data and sources behind each one.

26 criteria with recorded statuses: 2 met · 19 not met · 0 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

NM_024408.3:c.7354C>T (p.Gln2452Ter) is a nonsense variant in the last exon of NOTCH2 that truncates the C-terminal portion of the PEST degradation domain.

The variant is absent from gnomAD v2.1 and v4.1, meeting PM2 at moderate strength.

The truncation removes part of the PEST domain, a well-characterized functional domain responsible for NOTCH2 protein degradation, meeting PM1 at moderate strength.

PVS1 is not met because NOTCH2 PEST domain truncations are established as gain-of-function (Hajdu-Cheney syndrome), not loss-of-function, and the alteration predicts NMD escape.

No variant-specific functional data, de novo reports, segregation data, or ClinVar classifications are available. Remaining criteria are not met or not applicable.

Overall evidence: 2 moderate pathogenic criteria (PM1 + PM2) with no benign criteria. This combination does not reach the threshold for Likely Pathogenic under generic ACMG/AMP 2015 rules (requires 2 moderate + 2 supporting, or 3 moderate, or 1 strong + 1-2 moderate). The variant is classified as a Variant of Uncertain Significance (VUS).

Met · 2

PM1 ModerateThe variant p.Gln2452Ter truncates the C-terminal portion of the NOTCH2 PEST domain (approx. aa 2418-2472), a well-established functional domain responsible for ubiquitin-mediated protein degradation. PEST domain truncations in NOTCH2 are a characterized pathogenic mechanism causing Hajdu-Cheney syndrome (PMID:21378989) and have been identified in DLBCL (PMID:25314575). Truncation of this degradation domain leads to gain-of-function via increased NOTCH2 protein stability. A well-characterized functional domain in the literature satisfies PM1 for truncating variants that remove or disrupt it. Details ▾Hide ▴
Evidence considered
  • Variant truncates the PEST degradation domain (removes aa 2452-2472)
  • PEST domain is a well-characterized functional domain controlling NOTCH2 protein turnover
  • PEST domain truncations are a known disease mechanism in Hajdu-Cheney syndrome and DLBCL
  • OncoKB confirms biological context as gain-of-function via PEST disruption
Sources
PM2 ModerateNM_024408.3:c.7354C>T is absent from gnomAD v2.1 and v4.1, meeting the PM2 threshold of allele frequency <0.1% in population databases. Details ▾Hide ▴
Evidence considered
  • Absent from gnomAD v2.1 (exomes)
  • Absent from gnomAD v4.1 (genomes/exomes)
  • Absent from gnomAD-Canada v1.0
Sources

Not met · 19 · evaluated, threshold not reached

PVS1 NM_024408.3:c.7354C>T is a nonsense variant (p.Gln2452Ter) in the last coding exon (exon 34/34), which escapes nonsense-mediated decay. Under PMC6185798, PVS1 requires a null variant in a gene where loss-of-function is a known disease mechanism. The truncated region (aa 2452-2472) encompasses the C-terminal portion of the PEST degradation domain. NOTCH2 PEST domain truncations are well-established as gain-of-function — the mutant protein escapes ubiquitin-mediated degradation, leading to sustained NOTCH2 signaling. This is the mechanism for Hajdu-Cheney syndrome (PMID:21378989) and has been demonstrated in lymphoma models (PMID:25314575). OncoKB classifies this variant as 'Likely Gain-of-function.' Because the predicted functional consequence is gain-of-function, not loss-of-function, PVS1 is not applicable. Details ▾Hide ▴
Evidence considered
  • Nonsense variant in last exon (exon 34/34
  • c.7354C>T) predicted to escape NMD
  • Truncation removes C-terminal 20 amino acids (aa 2452-2472) including part of the PEST degradation domain
  • NOTCH2 PEST domain truncations are a known gain-of-function mechanism (Hajdu-Cheney syndrome
  • DLBCL)
  • OncoKB classifies as Likely Gain-of-function
Sources
PS2 No de novo observation has been reported for NM_024408.3:c.7354C>T. The variant is absent from ClinVar and no case reports document de novo inheritance. Details ▾Hide ▴
Evidence considered
  • Variant absent from ClinVar
  • No de novo reports identified in literature
Still missing
  • No family or trio sequencing data available
PS3 No variant-specific functional data exists for NM_024408.3:c.7354C>T (p.Gln2452Ter). While functional studies characterize NOTCH2 PEST domain truncations broadly, available literature tested different PEST domain positions (e.g., c.7605G>A in PMID:25314575; various Hajdu-Cheney truncations in PMID:21378989) — none directly assayed the c.7354C>T variant or a systematic range that includes position 2452. Per PS3 calibration rules, domain-level inference from sparse testing falls under PM1, not PS3. Details ▾Hide ▴
Evidence considered
  • PMID:25314575 tested c.7605G>A (p.W2435*) in the PEST domain — a different nonsense position
  • PMID:21378989 reported Hajdu-Cheney syndrome last-exon truncations but did not directly test c.7354C>T
  • No systematic saturation mutagenesis or tiling screen spans position 2452
Still missing
  • No variant-specific functional assay for c.7354C>T
  • No systematic range characterization that includes codon 2452
Sources
PS4 The variant is absent from ClinVar and gnomAD, so the prevalence in affected individuals versus controls cannot be assessed. No case-control data are available. Details ▾Hide ▴
Evidence considered
  • Absent from gnomAD v2.1 and v4.1
  • Absent from ClinVar
Still missing
  • No case-control or cohort data available for this variant
Sources
PM5 No same-residue comparator variants were identified via ClinVar harvesting. The pm5_candidates pipeline flagged this as not applicable due to inability to confirm classic same-residue PM5 semantics. Manual review of the literature also identified no pathogenic variant at codon 2452 distinct from Q2452Ter. Details ▾Hide ▴
Evidence considered
  • Automated ClinVar harvesting found zero same-residue candidates
  • Manual literature review identified no alternative pathogenic alteration at codon 2452
Sources
pm5_candidates
PM6 No de novo report has been identified for NM_024408.3:c.7354C>T. No trio sequencing data or de novo confirmation is available. Details ▾Hide ▴
Evidence considered
  • Variant absent from ClinVar
  • No de novo publications identified
Still missing
  • No trio or family-based sequencing data
PP1 No segregation data are available for this variant. The variant has not been reported in any family studies. Details ▾Hide ▴
Still missing
  • No family segregation data available
PP3 SpliceAI predicts no significant splice impact (max delta score = 0.02). REVEL score is unavailable for this variant. BayesDel score is 0.578, which is in the ambiguous range and does not meet a pathogenic threshold for a nonsense variant. For stop-gain variants, in silico predictors of pathogenicity are not well calibrated — the functional effect is determined by the protein truncation itself, not nucleotide conservation scores. Details ▾Hide ▴
Evidence considered
  • SpliceAI max delta = 0.02 (no predicted splicing impact)
  • BayesDel = 0.578 (ambiguous range)
  • REVEL not available
Sources
spliceai ↗bayesdel
PP4 No patient phenotype data are available for this assessment. PP4 requires a variant to be identified in a patient whose phenotype or family history is highly specific for the gene/disease. Details ▾Hide ▴
Still missing
  • No patient phenotype or clinical indication provided
PP5 The variant is absent from ClinVar. PP5 requires a pathogenic classification from a reputable source (ClinVar expert panel with ≥3-star review status), which is not available. Details ▾Hide ▴
Evidence considered
  • Variant absent from ClinVar — no classification available
Sources
BA1 The variant is absent from gnomAD v2.1 and v4.1. BA1 requires an allele frequency >5% in any general population, which is not met. Details ▾Hide ▴
Evidence considered
  • Absent from gnomAD v2.1
  • Absent from gnomAD v4.1
Sources
BS1 The variant is absent from gnomAD. BS1 requires an allele frequency >0.3% (non-VCEP threshold) or greater than expected for the disorder, which is not met. Details ▾Hide ▴
Evidence considered
  • Absent from gnomAD v2.1 and v4.1
Sources
BS2 No data are available regarding this variant in healthy adult individuals. The variant has not been observed in any population database. Details ▾Hide ▴
Still missing
  • No clinical or population data in healthy adults
BS3 No functional studies demonstrate a benign effect for this variant. The available functional literature on NOTCH2 PEST domain truncations supports a gain-of-function effect (increased protein stability and signaling), which is a pathogenic, not benign, mechanism. Details ▾Hide ▴
Evidence considered
  • PMID:21378989: NOTCH2 last-exon truncations cause Hajdu-Cheney syndrome via gain-of-function
  • PMID:25314575: NOTCH2 PEST domain truncation activates NF-κB signaling
  • enhancing proliferation
Sources
BS4 No segregation data are available. BS4 requires lack of segregation with disease in affected family members. Details ▾Hide ▴
Still missing
  • No family segregation data
BP2 No observation of this variant in trans with a known pathogenic variant has been reported. No phase data are available. Details ▾Hide ▴
Still missing
  • No phase or co-occurrence data
BP4 Multiple lines of computational evidence do not suggest a benign impact. SpliceAI predicts no splicing effect (max delta 0.02). BayesDel (0.578) is ambiguous. For a nonsense variant introducing a premature stop codon, computational prediction of benign impact is not persuasive. Details ▾Hide ▴
Evidence considered
  • SpliceAI max delta = 0.02 (no splice impact)
  • BayesDel = 0.578 (ambiguous
  • not clearly benign)
Sources
spliceai ↗bayesdel
BP5 No alternative molecular basis for disease has been identified in a case harboring this variant. No data are available. Details ▾Hide ▴
Still missing
  • No case data with alternative molecular diagnosis
BP6 The variant is absent from ClinVar. BP6 requires a benign classification from a reputable source, which is not available. Details ▾Hide ▴
Evidence considered
  • Variant absent from ClinVar — no classification available
Sources
Not applicable · 5· recorded as not applicable Show reasons ▾Hide reasons ▴
PS1 N/ANonsense variant; PS1 requires a same amino acid change as a known pathogenic missense variant, which does not apply to stop-gain variants. Details ▾Hide ▴

No further detail was recorded.

PP2 N/APP2 specifically applies to missense variants in genes with a low rate of benign missense variation. This is a nonsense (stop-gain) variant, so PP2 is not applicable. Details ▾Hide ▴

No further detail was recorded.

BP1 N/ABP1 applies to missense variants in genes where truncating variants are the primary disease mechanism. This is a nonsense (truncating) variant, so BP1 is not applicable. Details ▾Hide ▴

No further detail was recorded.

BP7 N/ABP7 applies to synonymous variants with no predicted splice impact. This is a nonsense (stop-gain) variant, not a synonymous change, so BP7 is not applicable. Details ▾Hide ▴

No further detail was recorded.

PS5 N/APS5 is defined for a novel missense change at a residue where a different pathogenic missense variant has been identified. This variant is a nonsense (stop-gain), not a missense, so PS5 is not applicable. Details ▾Hide ▴

No further detail was recorded.

Identifiers

Gene
NOTCH2
Transcript
NM_024408.3
Coding (HGVS c.)
NM_024408.3:c.7354C>T
Protein (HGVS p.)
NP_077719.2:p.(Gln2452Ter)
GRCh38
chr1:119915368 G>A
GRCh37
chr1:120457991 G>A

Gene diagram

Every interpreted variant in NOTCH2, mapped onto the exon structure of NM_024408.3. Select a row to find it on the plot.

NOTCH2NM_024408.3
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

Absent from gnomAD-Canada v1.0.

SpliceAI and Pangolin

SpliceAI acceptor lossat +41 bp
0.000
SpliceAI acceptor gainat -51 bp
0.000
SpliceAI donor lossat -174 bp
0.020
SpliceAI donor gainat +47 bp
0.000
Pangolin splice lossmagnitude shown
-0.040
Pangolin splice gain
0.010

Other predictors

REVEL
Not available
BayesDel
0.578

How the predictions were used

PP3 SpliceAI predicts no significant splice impact (max delta score = 0.02). REVEL score is unavailable for this variant. BayesDel score is 0.578, which is in the ambiguous range and does not meet a pathogenic threshold for a nonsense variant. For stop-gain variants, in silico predictors of pathogenicity are not well calibrated — the functional effect is determined by the protein truncation itself, not nucleotide conservation scores. Details ▾Hide ▴
Evidence considered
  • SpliceAI max delta = 0.02 (no predicted splicing impact)
  • BayesDel = 0.578 (ambiguous range)
  • REVEL not available
Sources
spliceai ↗bayesdel
BP4 Multiple lines of computational evidence do not suggest a benign impact. SpliceAI predicts no splicing effect (max delta 0.02). BayesDel (0.578) is ambiguous. For a nonsense variant introducing a premature stop codon, computational prediction of benign impact is not persuasive. Details ▾Hide ▴
Evidence considered
  • SpliceAI max delta = 0.02 (no splice impact)
  • BayesDel = 0.578 (ambiguous
  • not clearly benign)
Sources
spliceai ↗bayesdel
BP7 N/ABP7 applies to synonymous variants with no predicted splice impact. This is a nonsense (stop-gain) variant, not a synonymous change, so BP7 is not applicable. Details ▾Hide ▴

No further detail was recorded.

Statement

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.02). BayesDel score = 0.577639.

2 paper records listed. 2 cited in the classification. None of the listed paper records explicitly indicates that the variant is named.

Cited in the classification

  • Truncating mutations in the last exon of NOTCH2 cause a rare skeletal disorder with osteoporosis.
    Reports that heterozygous nonsense and frameshift mutations clustering in the last coding exon of NOTCH2 cause Hajdu-Cheney syndrome, an autosomal dominant skeletal disorder. The mutations are predicted to escape nonsense-mediated decay, producing truncated proteins lacking the C-terminal PEST degradation domain, consistent with a gain-of-function mechanism. NM_024408.3:c.7354C>T was not among the specific mutations reported.
    → PM1 Does not name this variant
    PMID 21378989 ↗
    Source detail
    All mutations cluster to the last coding exon of the gene, suggesting that the mutant mRNA products escape nonsense-mediated mRNA decay

    Location Abstract

  • The truncate mutation of Notch2 enhances cell proliferation through activating the NF-&#x3ba;B signal pathway in the diffuse large B-cell lymphomas.
    Reports a recurrent c.7605G>A (p.Trp2435Ter) truncating mutation in the NOTCH2 PEST domain in 3 of 69 diffuse large B-cell lymphomas, demonstrating that PEST domain truncation enhances cell proliferation through NF-kappaB pathway activation. NM_024408.3:c.7354C>T (p.Gln2452Ter) was not identified in this study, though the paper establishes the functional consequence of PEST domain truncation as gain-of-function.
    → PM1 Does not name this variant
    PMID 25314575 ↗
    Source detail
    The identical mutation of the three DLBCLs was at the nucleotide 7605 (G/A) in the human NOTCH2 cDNA sequence, which was in the PEST domain and converted tryptophan 2435 into a stop codon.

    Location Results; Figure 1B; Table 1

    Context DLBCL tumor samples; immunohistochemistry for Notch2, P65, P50, Ki67; NF-kappaB signaling assays

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

Absent from gnomAD-Canada v1.0.

ClinVar

This variant is absent from ClinVar.

In silico

SpliceAI predicts no significant splice impact for this variant (max delta score = 0.02). BayesDel score = 0.577639.

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 does not lie in a statistically significant hotspot. This variant has not previously been reported in somatic cancers (COSMIC).

Cancer Hotspots

This variant does not lie in a statistically significant hotspot.