16-68819393-C-G
Variant summary
Our verdict is Pathogenic. The variant received 14 ACMG points: 14P and 0B. PP3PM2_SupportingPS3PS4PP1_Strong
This summary comes from the ClinGen Evidence Repository: The c.1679C>G (p.Thr560Arg) variant is absent in the gnomAD cohort (PM2_Supporting; http://gnomad.broadinstitute.org). There are at least 3 in silico predictors in agreement that this variant affects splicing (PP3). There is also an RNA assay demonstrating abnormal out-of-frame transcript (PS3; PMID:27880784). Additionally, the variant was found to co-segregation with disease in multiple affected family members, with >7 meioses observed across at least 4 families (PP1_Strong; PMID:27880784, 29769627). This variant has been reported in at least 4 families meeting HDGC clinical criteria (PS4; PMID:27880784, 29769627, 23709761 and SCV000580704.2). In summary, this variant meets criteria to be classified as pathogenic based on the ACMG/AMP criteria applied as specified by the CDH1 Variant Curation Expert Panel (Variant Interpretation Guidelines Version 3.1): PM2_Supporting, PP3, PS3, PP1_Strong, PS4. LINK:https://erepo.genome.network/evrepo/ui/classification/CA10577547/MONDO:0007648/007
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: Pathogenic. The variant received 14 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| CDH1 | NM_004360.5 | c.1679C>G | p.Thr560Arg | missense_variant | Exon 11 of 16 | ENST00000261769.10 | NP_004351.1 | |
| CDH1 | NM_001317184.2 | c.1496C>G | p.Thr499Arg | missense_variant | Exon 10 of 15 | NP_001304113.1 | ||
| CDH1 | NM_001317185.2 | c.131C>G | p.Thr44Arg | missense_variant | Exon 11 of 16 | NP_001304114.1 | ||
| CDH1 | NM_001317186.2 | c.-254-2608C>G | intron_variant | Intron 10 of 14 | NP_001304115.1 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| CDH1 | ENST00000261769.10 | c.1679C>G | p.Thr560Arg | missense_variant | Exon 11 of 16 | 1 | NM_004360.5 | ENSP00000261769.4 |
Frequencies
GnomAD3 genomes Cov.: 31
GnomAD4 exome AF: 6.84e-7 AC: 1AN: 1461542Hom.: 0 Cov.: 32 AF XY: 0.00 AC XY: 0AN XY: 727064 show subpopulations
Age Distribution
GnomAD4 genome Cov.: 31
ClinVar
Submissions by phenotype
Hereditary diffuse gastric adenocarcinoma Pathogenic:4
This variant is considered likely pathogenic. mRNA analysis has demonstrated abnormal mRNA splicing occurs [PMID: 27880784]. This variant has been reported in multiple individuals with clinical features of gene-specific disease [PMID: 23709761, 26182300, 27880784]. -
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This sequence change replaces threonine, which is neutral and polar, with arginine, which is basic and polar, at codon 560 of the CDH1 protein (p.Thr560Arg). RNA analysis indicates that this missense change induces altered splicing and may result in an absent or altered protein product. This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individuals with diffuse gastric cancer (PMID: 23709761, 27880784, 29769627, 30745422). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 234554). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. Studies have shown that this missense change results in activation of a cryptic donor splice site and introduces a premature termination codon (PMID: 27880784, 29769627). The resulting mRNA is expected to undergo nonsense-mediated decay. For these reasons, this variant has been classified as Pathogenic. -
PS3; PS4; PM2; PP1_Strong; PP3 (PMID: 30311375) -
Hereditary cancer-predisposing syndrome Pathogenic:2
The c.1679C>G variant (also known as p.T560R), located in coding exon 11 of the CDH1 gene, results from a C to G substitution at nucleotide position 1679. The threonine at codon 560 is replaced by arginine, an amino acid with similar properties. This nucleotide position is not well conserved in available vertebrate species. Multiple studies have described this alteration in families meeting diagnostic criteria for Hereditary Diffuse Gastric Cancer syndrome. In addition, this alteration has been observed to segregate with disease in at least 4 families (Benusiglio PR et al. J. Med. Genet. 2013 Jul;50:486-9; Yelskaya Z et al. PLoS ONE 2016 Nov;11(11):e0165654; Pena-Couso L et al. Eur. J. Hum. Genet. 2018 09;26(9):1348-1353). In silico splice site analysis predicts that this alteration will result in the creation or strengthening of a novel splice donor site. RNA assay has demonstrated the creation of a novel splice donor site causing a frameshift and premature protein truncation (Yelskaya Z et al. PLoS ONE 2016 Nov;11(11):e0165654; Pena-Couso L et al. Eur. J. Hum. Genet. 2018 09;26(9):1348-1353; Ambry internal data). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
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not provided Pathogenic:1
The CDH1 c.1679C>G (p.Thr560Arg) variant activates a cryptic splice donor site and has been shown in the published literature to cause aberrant mRNA splicing and the production of a truncated CDH1 transcript (PMID: 27880784 (2016)). Further experimental studies showed this variant has deleterious effects on CDH1 protein function (PMID: 29769627 (2018)). This variant has been reported in multiple individuals with diffused gastric cancer and lobular breast cancer (PMIDs: 36436516 (2022), 34949788 (2022), 29769627 (2018), 23709761 (2013)), and segregated with disease in at least two families with HDGC (PMIDs: 33268956 (2020), 27880784 (2016)). This variant has not been reported in large, multi-ethnic general populations (Genome Aggregation Database, http://gnomad.broadinstitute.org). Based on the available information, this variant is classified as pathogenic. -
Gastric cancer Pathogenic:1
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CDH1-related diffuse gastric and lobular breast cancer syndrome Pathogenic:1
The c.1679C>G (p.Thr560Arg) variant is absent in the gnomAD cohort (PM2_Supporting; http://gnomad.broadinstitute.org). There are at least 3 in silico predictors in agreement that this variant affects splicing (PP3). There is also an RNA assay demonstrating abnormal out-of-frame transcript (PS3; PMID: 27880784). Additionally, the variant was found to co-segregation with disease in multiple affected family members, with >7 meioses observed across at least 4 families (PP1_Strong; PMID: 27880784, 29769627). This variant has been reported in at least 4 families meeting HDGC clinical criteria (PS4; PMID: 27880784, 29769627, 23709761 and SCV000580704.2). In summary, this variant meets criteria to be classified as pathogenic based on the ACMG/AMP criteria applied as specified by the CDH1 Variant Curation Expert Panel (Variant Interpretation Guidelines Version 3.1): PM2_Supporting, PP3, PS3, PP1_Strong, PS4. -
Familial cancer of breast Pathogenic:1
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not specified Uncertain:1
This variant was observed in at least one individual diagnosed with early-onset diffuse gastric cancer (Benusiglio 2013). CDH1 Thr560Arg was not observed in approximately 6,500 individuals of European and African American ancestry in the NHLBI Exome Sequencing Project, indicating it is not a common benign variant in these populations. Since Threonine and Arginine differ in some properties, this is considered a semi-conservative amino acid substitution. CDH1 Thr560Arg occurs at a position that is conserved in mammals and is located in the Cadherin 4 domain (UniProt). In silico analyses predict that this variant is probably damaging to protein structure and function. Based on currently available evidence, it is unclear whether CDH1 Thr560Arg is pathogenic or benign. We consider it to be a variant of uncertain significance. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at