Our verdict is Pathogenic. The variant received 18 ACMG points: 18P and 0B. PVS1PM2PP5_Very_Strong
The NM_000038.6(APC):c.3830T>G(p.Leu1277*) variant causes a stop gained change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Likely pathogenic (★★). Synonymous variant affecting the same amino acid position (i.e. L1277L) has been classified as Likely benign.
APC (HGNC:583): (APC regulator of WNT signaling pathway) This gene encodes a tumor suppressor protein that acts as an antagonist of the Wnt signaling pathway. It is also involved in other processes including cell migration and adhesion, transcriptional activation, and apoptosis. Defects in this gene cause familial adenomatous polyposis (FAP), an autosomal dominant pre-malignant disease that usually progresses to malignancy. Mutations in the APC gene have been found to occur in most colorectal cancers, where disease-associated mutations tend to be clustered in a small region designated the mutation cluster region (MCR) and result in a truncated protein product. [provided by RefSeq, Jun 2022]
APC Gene-Disease associations (from GenCC):
classic or attenuated familial adenomatous polyposis
Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
desmoid tumor
Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Genomics England PanelApp
familial adenomatous polyposis 1
Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Ambry Genetics
gastric adenocarcinoma and proximal polyposis of the stomach
Our verdict: Pathogenic. The variant received 18 ACMG points.
PVS1
Loss of function variant, product does not undergo nonsense mediated mRNA decay. Variant is located in the 3'-most exon, not predicted to undergo nonsense mediated mRNA decay. There are 867 pathogenic variants in the truncated region.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 5-112839424-T-G is Pathogenic according to our data. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112839424-T-G is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 188239.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
This sequence change creates a premature translational stop signal (p.Leu1277*) in the APC gene. While this is not anticipated to result in nonsense mediated decay, it is expected to disrupt the last 1567 amino acid(s) of the APC protein. This variant is not present in population databases (gnomAD no frequency). This premature translational stop signal has been observed in individuals with familial adenomatous polyposis (PMID: 23159591). ClinVar contains an entry for this variant (Variation ID: 188239). This variant disrupts a region of the APC protein in which other variant(s) (p.Tyr2645Lysfs*14) have been determined to be pathogenic (PMID: 1316610, 8381579, 9824584, 22135120, 27081525; Invitae). This suggests that this is a clinically significant region of the protein, and that variants that disrupt it are likely to be disease-causing. For these reasons, this variant has been classified as Pathogenic. -