16-68808756-A-T
Variant summary
Our verdict is Likely benign. The variant received -2 ACMG points: 2P and 4B. PM2BP4_Strong
The NM_004360.5(CDH1):c.595A>T(p.Thr199Ser) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0000031 in 1,614,050 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 17/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. T199K) has been classified as Likely benign.
Frequency
Consequence
NM_004360.5 missense
Scores
Clinical Significance
Conservation
Publications
- blepharocheilodontic syndrome 1Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Ambry Genetics, Illumina, Labcorp Genetics (formerly Invitae), G2P
 - CDH1-related diffuse gastric and lobular breast cancer syndromeInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), ClinGen, G2P
 - hereditary breast carcinomaInheritance: AD Classification: DEFINITIVE Submitted by: Ambry Genetics
 - hereditary diffuse gastric adenocarcinomaInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: Ambry Genetics, Orphanet
 - cleft soft palateInheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
 - orofacial cleft 3Inheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
 - blepharocheilodontic syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
 - familial ovarian cancerInheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
 
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ACMG classification
Our verdict: Likely_benign. The variant received -2 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt | 
|---|---|---|---|---|---|---|---|---|
| CDH1 | NM_004360.5  | c.595A>T | p.Thr199Ser | missense_variant | Exon 5 of 16 | ENST00000261769.10 | NP_004351.1 | |
| CDH1 | NM_001317184.2  | c.595A>T | p.Thr199Ser | missense_variant | Exon 5 of 15 | NP_001304113.1 | ||
| CDH1 | NM_001317185.2  | c.-1021A>T | 5_prime_UTR_variant | Exon 5 of 16 | NP_001304114.1 | |||
| CDH1 | NM_001317186.2  | c.-1225A>T | 5_prime_UTR_variant | Exon 5 of 15 | NP_001304115.1 | 
Ensembl
Frequencies
GnomAD3 genomes   AF:  0.00000657  AC: 1AN: 152194Hom.:  0  Cov.: 32 show subpopulations 
GnomAD2 exomes  AF:  0.00000796  AC: 2AN: 251252 AF XY:  0.00000736   show subpopulations 
GnomAD4 exome  AF:  0.00000274  AC: 4AN: 1461856Hom.:  0  Cov.: 32 AF XY:  0.00000413  AC XY: 3AN XY: 727234 show subpopulations 
Age Distribution
GnomAD4 genome   AF:  0.00000657  AC: 1AN: 152194Hom.:  0  Cov.: 32 AF XY:  0.0000134  AC XY: 1AN XY: 74356 show subpopulations 
ClinVar
Submissions by phenotype
not provided    Uncertain:2 
The CDH1 c.595A>T (p.Thr199Ser) variant has been reported in the published literature in an individual with suspected Lynch syndrome (PMID: 25980754 (2015)).The frequency of this variant in the general population, 0.00016 (4/24970 chromosomes in African/African American subpopulation (Genome Aggregation Database, http://gnomad.broadinstitute.org)), is higher than would generally be expected for pathogenic variants in this gene. Analysis of this variant using bioinformatics tools for the prediction of the effect of amino acid changes on protein structure and function yielded predictions that this variant is benign. Based on the available information, we are unable to determine the clinical significance of this variant. -
Not observed at a significant frequency in large population cohorts (Lek 2016); In silico analysis supports that this missense variant does not alter protein structure/function; Observed in individuals with cancer and/or polyps (Yurgelun 2015); This variant is associated with the following publications: (PMID: 25980754) -
Hereditary cancer-predisposing syndrome    Uncertain:1Benign:1 
This missense variant replaces threonine with serine at codon 199 of the CDH1 protein. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in an individual suspected on Lynch Syndrome in the literature (PMID: 25980754). This variant has been identified in 4/282656 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
This alteration is classified as benign based on a combination of the following: seen in unaffected individuals, population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -
not specified    Uncertain:1 
Variant summary: CDH1 c.595A>T (p.Thr199Ser) results in a conservative amino acid change located in the Cadherin-like domain of the encoded protein sequence. Five of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 8e-06 in 251252 control chromosomes. The available data on variant occurrences in the general population are insufficient to allow any conclusion about variant significance. c.595A>T has been reported in the literature in an individual with suspected Lynch Syndrome (Yurgelun_2015). These report(s) do not provide unequivocal conclusions about association of the variant with Breast Cancer. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Three clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 without evidence for independent evaluation. All laboratories classified the variant as uncertain significance. Based on the evidence outlined above, the variant was classified as uncertain significance. -
Hereditary diffuse gastric adenocarcinoma    Uncertain:1 
This sequence change replaces threonine, which is neutral and polar, with serine, which is neutral and polar, at codon 199 of the CDH1 protein (p.Thr199Ser). This variant is present in population databases (no rsID available, gnomAD 0.02%). This missense change has been observed in individual(s) with a Lynch syndrome-associated cancer and/or colorectal polyps (PMID: 25980754). ClinVar contains an entry for this variant (Variation ID: 230166). An algorithm developed to predict the effect of missense changes on protein structure and function outputs the following: PolyPhen-2: "Benign". The serine amino acid residue is found in multiple mammalian species, which suggests that this missense change does not adversely affect protein function. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
Computational scores
Source: 
Splicing
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at