rs201531372
Variant summary
Our verdict is Benign. Variant got -13 ACMG points: 0P and 13B. BP4_StrongBP6BS1BS2
The NM_004655.4(AXIN2):c.623C>T(p.Ala208Val) variant causes a missense change. The variant allele was found at a frequency of 0.000194 in 1,614,160 control chromosomes in the GnomAD database, including 2 homozygotes. In-silico tool predicts a benign outcome for this variant. 12/19 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_004655.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Benign. Variant got -13 ACMG points.
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
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AXIN2 | ENST00000307078.10 | c.623C>T | p.Ala208Val | missense_variant | Exon 2 of 11 | 1 | NM_004655.4 | ENSP00000302625.5 | ||
ENSG00000266076 | ENST00000577662.1 | n.*799C>T | non_coding_transcript_exon_variant | Exon 4 of 7 | 2 | ENSP00000462418.1 | ||||
ENSG00000266076 | ENST00000577662.1 | n.*799C>T | 3_prime_UTR_variant | Exon 4 of 7 | 2 | ENSP00000462418.1 |
Frequencies
GnomAD3 genomes AF: 0.000256 AC: 39AN: 152148Hom.: 0 Cov.: 32
GnomAD3 exomes AF: 0.000243 AC: 61AN: 251478Hom.: 0 AF XY: 0.000250 AC XY: 34AN XY: 135918
GnomAD4 exome AF: 0.000188 AC: 275AN: 1461894Hom.: 2 Cov.: 31 AF XY: 0.000216 AC XY: 157AN XY: 727248
GnomAD4 genome AF: 0.000250 AC: 38AN: 152266Hom.: 0 Cov.: 32 AF XY: 0.000255 AC XY: 19AN XY: 74446
ClinVar
Submissions by phenotype
not provided Uncertain:2Benign:1
In silico analysis indicates that this missense variant does not alter protein structure/function; Observed in individuals with a personal or family history of colorectal and other cancers (PMID: 28577310, 28944238, 29212164); This variant is associated with the following publications: (PMID: 29641532, 28944238, 29212164, 28577310) -
The AXIN2 p.Ala208Val variant was identified in dbSNP (ID: rs201531372), ClinVar (classified as likely benign by Illumina and as a VUS by GeneDx and Invitae for Oligodontia-colorectal cancer syndrome) and LOVD 3.0 but was not found in Cosmic. The variant was identified in control databases in 63 of 282882 chromosomes at a frequency of 0.000223 (Genome Aggregation Database Feb 27, 2017). The variant was observed in the following populations: South Asian in 25 of 30616 chromosomes (freq: 0.000817), Other in 3 of 7228 chromosomes (freq: 0.000415), Latino in 8 of 35440 chromosomes (freq: 0.000226), European (non-Finnish) in 25 of 129186 chromosomes (freq: 0.000194), Ashkenazi Jewish in 1 of 10368 chromosomes (freq: 0.000096) and European (Finnish) in 1 of 25124 chromosomes (freq: 0.00004); it was not observed in the African and East Asian populations. The c.623C>T variant was identified somatically in one patient affected with Lynch Syndrome (Vargas-Parra_2017_PMID: 28566310). 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 p.Ala208 residue is conserved in mammals but not in more distantly related organisms however four out of five computational analyses (PolyPhen-2, SIFT, AlignGVGD, BLOSUM, MutationTaster) do not suggest a high likelihood of impact to the protein; this information is not predictive enough to rule out pathogenicity. In summary, based on the above information, the clinical significance of this variant canont be determined with certainty at this time. The variant is classified as a variant of uncertain significance. -
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not specified Uncertain:1Benign:1
Variant summary: AXIN2 c.623C>T (p.Ala208Val) results in a non-conservative amino acid change in the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 0.00024 in 251478 control chromosomes, predominantly at a frequency of 0.00082 within the South Asian subpopulation in the gnomAD database. The observed variant frequency within South Asian control individuals in the gnomAD database is approximately 6 fold of the estimated maximal expected allele frequency for a pathogenic variant in AXIN2 causing colorectal cancer (0.00014), suggesting that the variant is a benign polymorphism found primarily in populations of South Asian origin. c.623C>T has been reported in the literature in settings of multigene panel testing in individuals affected with colorectal cancer, without strong evidence for causality (e.g. Vargas-Parra_2017, DeRycke_2017, Raskin_2017). These reports do not provide unequivocal conclusions about association of the variant with colorectal cancer. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. Six clinical diagnostic laboratories have submitted clinical-significance assessments for this variant to ClinVar after 2014 with conflicting assessments. The majority classified the variant as either benign (n=1) or likely benign (n=3), and the others classified the variant as VUS (n=2). Based on the evidence outlined above, the variant was classified as likely benign. -
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Oligodontia-cancer predisposition syndrome Benign:2
This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -
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Hereditary cancer-predisposing syndrome Benign:2
This alteration is classified as likely 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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AXIN2-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