Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PVS1_ModeratePM2PP5_Very_Strong
The NM_000038.6(APC):c.532-1G>A variant causes a splice acceptor, intron 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. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).
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 12 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, product NOT destroyed by NMD, known LOF gene, truncates exone, which is 0.013361462 fraction of the gene. Cryptic splice site detected, with MaxEntScore 8.6, offset of 16, new splice context is: ttaattttccttacaaacAGata. Cryptic site results in frameshift change. If cryptic site found is not functional and variant results in exon loss, it results in inframe change.
PM2
Very rare variant in population databases, with high coverage;
PP5
Variant 5-112780789-G-A is Pathogenic according to our data. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr5-112780789-G-A is described in CliVar as Pathogenic/Likely_pathogenic. Clinvar id is 439410.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
This sequence change affects an acceptor splice site in intron 5 of the APC gene. It is expected to disrupt RNA splicing. Variants that disrupt the donor or acceptor splice site typically lead to a loss of protein function (PMID: 16199547), and loss-of-function variants in APC are known to be pathogenic (PMID: 17963004, 20685668). This variant is not present in population databases (gnomAD no frequency). Disruption of this splice site has been observed in individuals with familial adenomatous polyposis (PMID: 9950360, 20685668). ClinVar contains an entry for this variant (Variation ID: 439410). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. For these reasons, this variant has been classified as Pathogenic. -
Aug 01, 2023
Baylor Genetics
Significance:Pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing
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Apr 26, 2023
Myriad Genetics, Inc.
Significance:Likely pathogenic
Review Status:criteria provided, single submitter
Collection Method:clinical testing
This variant is considered likely pathogenic. This variant occurs within a consensus splice junction and is predicted to result in abnormal mRNA splicing of either an out-of-frame exon or an in-frame exon necessary for protein stability and/or normal function. -
not specifiedPathogenic:1
Jan 13, 2017
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
The c.532-1G>A intronic pathogenic mutation results from a G to A substitution one nucleotide upstream from coding exon 5 of the APC gene. This alteration has been observed in individuals with a personal and/or family history that is consistent with APC-related disease (Wallis YL et al. J Med Genet, 1999 Jan;36:14-20; Lagarde A et al. J Med Genet, 2010 Oct;47:721-2; Ambry internal data). RNA studies have demonstrated that this alteration results in abnormal splicing in the set of samples tested (Ambry internal data). In addition to the clinical data presented in the literature, alterations that disrupt the canonical splice site are expected to cause aberrant splicing, resulting in an abnormal protein or a transcript that is subject to nonsense-mediated mRNA decay. As such, this alteration is interpreted as a disease-causing mutation. -