chr5-112838946-A-G
Variant summary
Our verdict is Benign. The variant received -16 ACMG points: 0P and 16B. BP4_StrongBP6_Very_StrongBS2
The NM_000038.6(APC):c.3352A>G(p.Asn1118Asp) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000216 in 1,614,040 control chromosomes in the GnomAD database, including 3 homozygotes. In-silico tool predicts a benign outcome for this variant. 16/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Likely benign (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. N1118S) has been classified as Uncertain significance.
Frequency
Consequence
NM_000038.6 missense
Scores
Clinical Significance
Conservation
Publications
- classic or attenuated familial adenomatous polyposisInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- desmoid tumorInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Genomics England PanelApp
- familial adenomatous polyposis 1Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Ambry Genetics
- gastric adenocarcinoma and proximal polyposis of the stomachInheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), ClinGen, Orphanet
- sarcomaInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- APC-related attenuated familial adenomatous polyposisInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Turcot syndrome with polyposisInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Cenani-Lenz syndactyly syndromeInheritance: AR Classification: SUPPORTIVE Submitted by: Orphanet
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ACMG classification
Our verdict: Benign. The variant received -16 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
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APC | ENST00000257430.9 | c.3352A>G | p.Asn1118Asp | missense_variant | Exon 16 of 16 | 5 | NM_000038.6 | ENSP00000257430.4 | ||
ENSG00000258864 | ENST00000520401.1 | n.228+9974A>G | intron_variant | Intron 3 of 7 | 3 | ENSP00000454861.1 |
Frequencies
GnomAD3 genomes AF: 0.000210 AC: 32AN: 152206Hom.: 1 Cov.: 32 show subpopulations
GnomAD2 exomes AF: 0.000423 AC: 106AN: 250530 AF XY: 0.000421 show subpopulations
GnomAD4 exome AF: 0.000217 AC: 317AN: 1461834Hom.: 2 Cov.: 33 AF XY: 0.000221 AC XY: 161AN XY: 727212 show subpopulations
GnomAD4 genome AF: 0.000210 AC: 32AN: 152206Hom.: 1 Cov.: 32 AF XY: 0.000161 AC XY: 12AN XY: 74358 show subpopulations
ClinVar
Submissions by phenotype
not specified Uncertain:1Benign:4
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Variant summary: The APC c.3352A>G (p.Asn1118Asp) variant involves the alteration of a conserved nucleotide. 4/4 in silico tools predict a benign outcome for this variant (SNPsandGO not captured due to low reliability index). This variant was found in 110/278362 control chromosomes, predominantly observed in the Ashkenazi Jewish subpopulation at a frequency of 0.009593 (97/10112). This frequency is about 134 times the estimated maximal expected allele frequency of a pathogenic APC variant (0.0000714), suggesting this is likely a benign polymorphism found primarily in the populations of Ashkenazi Jewish origin. This variant has been reported in multiple affected individuals and two families with evidence of lack of co-segregation of variant with disease (Nagase_1992 and Zhou_2004). Moreover, one colon cancer patient also carried a pathogenic BRCA2 variant c.5946del/p.S1982RfsX22 (Pearlman_2016), further supporting the benign nature of this variant. In addition, multiple clinical diagnostic laboratories/reputable databases classified this variant as benign/likely benign; one other lab classified it as VUS, all without evidence for independent evaluation. Taken together, especially considering the high MAF in controls, evidence of lack of co-segregation of variant with disease, and co-occurrence with another pathogenic variant, this variant is classified as benign. -
The APC p.Asn1118Asp variant was identified in 5 of 1626 proband chromosomes (frequency: 0.003) from individuals or families with FAP, CRC, or atherosclerosis and was not identified in 384 control chromosomes from healthy individuals (Nagase 1992, Zhou 2004, Johnston 2012). The variant was also identified in dbSNP (ID: rs140493115) as "With other allele", in ClinVar (classified as benign by Invitae, Ambry Genetics, and Quest Diagnostics; as likely benign by GeneDx, Color Genomics, EGL, and True Health Diagnostics; as uncertain significance by Mayo Clinic and Biesecker Lab), LOVD 3.0 (classified as likely benign by one submitter and uncertain significance by one submitter). The variant was also identified by our laboratory in 1 individual with colon cancer. The variant was identified in control databases in 110 of 276246 chromosomes at a frequency of 0.0004 increasing the likelihood this could be a low frequency benign variant (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: Other in 3 of 6454 chromosomes (freq: 0.0005), Latino in 1 of 34378 chromosomes (freq: 0.00003), European Non-Finnish in 9 of 126002 chromosomes (freq: 0.00007), Ashkenazi Jewish in 97 of 10112 chromosomes (freq: 0.0096); it was not observed in the African, East Asian, Finnish, and South Asian populations. The p.Asn1118 residue is not conserved in mammals and computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of impact to the protein; however, this information is not predictive enough to rule out pathogenicity. The variant occurs outside of the splicing consensus sequence and in silico or computational prediction software programs (SpliceSiteFinder, MaxEntScan, NNSPLICE, GeneSplicer) do not predict a difference in splicing. The variant was also identified in a patient with CRC and a very strong family history of CRC as well as breast-ovarian cancer where it did not co-segregate with disease, specifically 2 members with colon cancer tested negative for the variant (Zhou 2004). In addition the variant was described to not segregate well with the disease phenotype in a family with FAP and a co-occurring pathogenic APC variant (Nagase 1992). The variant has also been identified in an individual with colorectal cancer co-occurring with a pathogenic variant (BRCA2, c.5946del, p.S1982Rfs*22; Pearlman 2017). In summary, based on the above information this variant meets our laboratory's criteria to be classified as benign. -
Hereditary cancer-predisposing syndrome Benign:5
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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. -
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not provided Uncertain:1Benign:3
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This variant is associated with the following publications: (PMID: 22703879, 25203624, 1338764, 15161437, 27621404, 28135145, 25231023, 15122587, 25148578, 27978560, 26373296, 22875147, 21859464, 25925381) -
APC: BS2 -
APC-Associated Polyposis Disorders Benign:1
This variant was observed as part of a predisposition screen in an ostensibly healthy population. A literature search was performed for the gene, cDNA change, and amino acid change (where applicable). Publications were found based on this search. The evidence from the literature, in combination with allele frequency data from public databases where available, was sufficient to determine this variant is unlikely to cause disease. Therefore, this variant is classified as likely benign. -
Familial adenomatous polyposis 1 Benign:1
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APC-related disorder Benign:1
This variant is classified as likely benign based on ACMG/AMP sequence variant interpretation guidelines (Richards et al. 2015 PMID: 25741868, with internal and published modifications). -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at