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NM_004655.4:c.1168A>G
p.Ser390Gly · AXIN2
ACMG/AMP
0%
complete
Final classification
Likely Benign
BS2BP1BP4
AXIN2
c.1168A>G
p.Ser390Gly
missense · exon 5

AXIN2 is a scaffolding protein that helps regulate the Wnt signaling pathway, a key developmental pathway controlling cell growth and fate. It is part of the beta-catenin destruction complex, where it helps mark beta-catenin for degradation when Wnt signaling is off, and it also assists in relaying Wnt signals to the nucleus when the pathway is active. AXIN2 acts as a tumor suppressor, and mutations in the gene have been linked to colorectal cancer as well as familial tooth agenesis with predisposition to colorectal cancer. Its expression has also been associated with prostate cancer recurrence.

This variant

AXIN2 encodes a tumor-suppressor scaffolding protein in the Wnt signaling pathway and is associated with colorectal cancer susceptibility and familial tooth agenesis.

Transcript
NM_004655.4
HGVS · transcript:coding
NM_004655.4:c.1168A>G
GRCh38
chr17:65538235 T>C
GRCh37
chr17:63534353 T>C
Likely Benign: BS2 strong plus BP1 and BP4 supporting satisfy the generic ACMG/AMP fallback combination rule.
Classification rationale
BS2BP1BP4 Likely Benign
AXIN2 c.1168A>G missense · exon 5

BS2 strong: gnomAD v4.1 reports two homozygotes, subject to phenotype and penetrance review. BP1 supporting: p.Ser390Gly is a missense variant in a loss-of-function AXIN2 disease mechanism. BP4 supporting: REVEL 0.286 and SpliceAI max delta 0.004 meet the benign computational thresholds.

BS2 + BP1 + BP4 Likely Benign
LYFE Sciences is an AI system, and it can make mistakes. Criteria may be applied incorrectly, sources may be misread, and a confident-looking classification can still be wrong. Double-check every criterion and its underlying evidence before relying on any call.
Gene diagram · NM_004655.4 · variants mapped to exon structure
AXIN2 NM_004655.4
Fetching transcript structure from UCSC…
Applied criteria · 3 applied · 21 assessed
MetEvidence satisfies this criterion.
Not metEvaluated against available evidence; threshold not reached.
Not assessedApplies in principle, but no evidence was found to evaluate it.
N/ADoesn't apply to this variant type.
Applied · 3
Strength Supporting Moderate Strong Very strong
BS2 strong review Benign
Met: gnomAD v4.1 reports two homozygotes, although phenotype and penetrance information require human review before relying fully on BS2.
gnomAD v4.1 reports two homozygotes overall and two homozygotes in the European (non-Finnish) subgroup.The gnomAD record is population data rather than a phenotype-confirmed healthy-adult cohort, so the BS2 interpretation is conditional on the usual population-database assumption and needs human review.The supplied case evidence identifies AXIN2-associated disease context but does not establish penetrance or clinical status of the homozygous gnomAD individuals.
BP1 supporting Benign
Met, supporting: this is a missense p.Ser390Gly variant in AXIN2, whose established germline disease mechanism is supported as loss of function.
The case identifies NM_004655.4:c.1168A>G as the missense change NP_004646.3:p.(Ser390Gly).The AXIN2 gene-context assessment supports loss of function as the germline disease mechanism and no AXIN2-specific VCEP rule is available.
BP4 supporting Benign
Met, supporting: REVEL 0.286 and SpliceAI max delta 0.004 both meet their supplied BP4 supporting thresholds of <=0.29 and <=0.1.
Missense consequence: NM_004655.4:c.1168A>G, NP_004646.3:p.(Ser390Gly).REVEL score is 0.286; the supplied generic calibration gives BP4 supporting at <=0.29, from Pejaver et al. 2022 (PMID:36413997).SpliceAI maximum delta score is 0.004; the supplied generic calibration gives BP4 supporting at <=0.1, from Jaganathan et al. 2019 (PMID:30661751).
Assessed · not applied · 11 not met · 10 not assessed
Pathogenic
PS1 Not met: the exact p.Ser390Gly variant was classified as a class 3 VUS, with no established pathogenic same-amino-acid substitution identified.
PS2 Not assessed: parental genotypes and confirmed maternity/paternity are not reported for the exact variant in the available patient record.
PS3 Not assessed: the exact variant was reported clinically, but no variant-specific functional assay result or experimental readout was provided.
PS4 Not met: one reported case provides no case-control enrichment or statistically significant excess for the exact AXIN2 variant.
PM1 Not met: no approved AXIN2 domain entry covers Ser390, and hotspot review found no statistically significant hotspot at residue 390.
PM2 Not met: gnomAD v4.1 total allele frequency is 0.00103457, exceeding the generic PM2 threshold of 0.0001.
PM3 Not assessed: no documented biallelic observation, pathogenic variant in trans, phase, or inheritance mode is available for AXIN2 c.1168A>G.
PM5 Not assessed: no same-residue comparator was available, and the PM5 search artifact could not confirm complete classic PM5 semantics.
PM6 Not assessed: no unconfirmed-parentage de novo observation is reported for the exact variant, and parental testing details are absent.
PP1 Not assessed: zero informative familial meioses or relative genotype-phenotype observations are reported for the exact variant.
PP2 Not met: AXIN2 disease mechanism is supported as loss of function, not as a gene with an established pathogenic-missense mechanism and rare benign missense variation.
PP3 Not met: SpliceAI max delta 0.004 and REVEL 0.286 are below the PP3 supporting thresholds of 0.2 and 0.644, respectively.
PP4 Not met: colorectal cancer with MSH2/MSH6 loss and high microsatellite instability is not a phenotype highly specific for AXIN2.
PP5 Not met: ClinVar shows zero expert-panel submissions and no exact-variant Pathogenic or Likely pathogenic expert-panel classification.
Benign
BA1 Not met: gnomAD v4.1 maximum population frequency is 0.00134658, far below the generic BA1 stand-alone threshold of 0.05.
BS1 Not met: gnomAD v4.1 maximum population frequency is 0.00134658, below the generic BS1 threshold of 0.01.
BS3 Not assessed: no validated assay demonstrated preserved AXIN2 function for the exact p.Ser390Gly variant.
BS4 Not assessed: no genotyped unaffected relatives or documented phenotype-discordant meioses are reported for the exact variant.
BP2 Not assessed: no documented cis or trans co-occurrence with a pathogenic variant is available for AXIN2 c.1168A>G.
BP5 Not assessed: MSH2/MSH6 loss is reported, but no confirmed alternate pathogenic molecular cause is identified to satisfy BP5.
BP6 Not met: ordinary ClinVar laboratory submissions cannot trigger BP6, and no exact-variant expert-panel Benign or Likely benign classification exists.
N/A · 4 PVS1 · PM4 · BP3 · BP7
Research & evidence
Population frequency · supports benign
gnomAD v4.1 screenshot
gnomAD v4.1
gnomAD v2.1 screenshot
gnomAD v2.1
v4.1
This variant is present in gnomAD v4.1 (AF= 0.00103457; MAF= 0.10346%, 1670/1614190 alleles, homozygotes = 2) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00134658; MAF= 0.13466%, 1589/1180030 alleles, homozygotes = 2); grpmax FAF= 0.00129138.
v2.1
This variant is present in gnomAD v2.1 (AF= 0.0007441; MAF= 0.07441%, 210/282220 alleles, homozygotes = 0) and has highest observed frequency in the European (non-Finnish) population (AF= 0.00142185; MAF= 0.14218%, 183/128706 alleles, homozygotes = 0); grpmax FAF= 0.00124203.
🇨🇦 CA
Not available in gnomAD-Canada v1.0.
Allele frequency by ancestry
three datasets · side by side
gnomAD v4.1
0.1% · 1670 / 1,614,190
2 hom · FAF 0.13%
European (non-Finnish)
1589 / 1,180,030
0.13%
2 hom
Remaining individuals
39 / 62,500
0.062%
European (Finnish)
24 / 64,032
0.037%
Admixed American
8 / 60,032
0.013%
African/African American
10 / 75,070
0.013%
+ 5 not observed (Amish, East Asian, Middle Eastern, South Asian, Ashkenazi Jewish)
gnomAD v2.1
0.074% · 210 / 282,220
0 hom · FAF 0.12%
European (non-Finnish)
183 / 128,706
0.14%
Remaining individuals
7 / 7,206
0.097%
European (Finnish)
8 / 25,094
0.032%
African/African American
5 / 24,886
0.02%
Admixed American
7 / 35,408
0.02%
+ 3 not observed (Ashkenazi Jewish, East Asian, South Asian)
gnomAD Canada 🇨🇦
Absent · 0 / ?
0 hom
Not observed in any ancestry group.
ClinVar screenshot
ClinVar
This variant has been reported in ClinVar as Likely benign (9 clinical laboratories) and as Uncertain significance (2 clinical laboratories) and as Benign (1 clinical laboratory) and as benign (1 clinical laboratory). (ClinVarID = 127934)
SpliceAI screenshot
In silico
SpliceAI predicts no significant splice impact for this variant (max delta score = 0.00). REVEL score = 0.286. BayesDel score = -0.266688.
Functional / OncoKB screenshot
Functional Unknown Oncogenic Effect
OncoKB did not identify variant-specific reviewed functional evidence for this variant; gene-level curated context is available for reviewer follow-up. AXIN2, a tumor suppressor involved in WNT signaling, is mutated at low frequencies in various cancer types.
OncoKB ↗
COSMIC screenshot
COSMIC
Cancer hotspots screenshot
Cancer hotspots
Somatic evidence Not in COSMIC / hotspots
COSMIC
This variant does not lie in a statistically significant hotspot. This variant has previously been reported in somatic cancers (COSMIC; COSV104596686, n = 1 times).
Hotspots
This variant does not lie in a statistically significant hotspot.
Sources & reference links
8Sources
ClinVar
gnomAD v2.1
gnomAD v4.1
gnomAD-Canada
SpliceAI
OncoKB
COSMIC
Cancer hotspots
Triaged references · 9 PMIDs not cited in assessment
25741868 ↗ Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. CLINVAR
26467025 ↗ A Standardized DNA Variant Scoring System for Pathogenicity Assessments in Mendelian Disorders. CLINVAR
27300758 ↗ Whole Gene Capture Analysis of 15 CRC Susceptibility Genes in Suspected Lynch Syndrome Patients. CLINVAR
28944238 ↗ Targeted sequencing of 36 known or putative colorectal cancer susceptibility genes. CLINVAR
30374176 ↗ Outcomes of 92 patient-driven family studies for reclassification of variants of uncertain significance. CLINVAR
20301390 ↗ Lynch Syndrome. CLINVAR
25394175 ↗ A practice guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: referral indications for cancer predisposition assessment. CLINVAR
26389258 ↗ Cancer Genetics Risk Assessment and Counseling (PDQ®): Health Professional Version. CLINVAR
28492532 ↗ Sherloc: a comprehensive refinement of the ACMG-AMP variant classification criteria. CLINVAR