Oligodontia-Colorectal Cancer via the AXIN2 Gene
Summary and Pricing 
Test Method
Sequencing and CNV Detection via NextGen Sequencing using PG-Select Capture Probes| Test Code | Test Copy Genes | Test CPT Code | Gene CPT Codes Copy CPT Code | Base Price | |
|---|---|---|---|---|---|
| 8307 | AXIN2 | 81479 | 81479,81479 | $990 | Order Options and Pricing |
Pricing Comments
Testing run on PG-select capture probes includes CNV analysis for the gene(s) on the panel but does not permit the optional add on of exome-wide CNV analysis. Any of the NGS platforms allow reflex to other clinically relevant genes, up to whole exome or whole genome sequencing depending upon the base platform selected for the initial test.
An additional 25% charge will be applied to STAT orders. STAT orders are prioritized throughout the testing process.
This test is also offered via a custom panel (click here) on our exome or genome backbone which permits the optional add on of exome-wide CNV or genome-wide SV analysis.
Turnaround Time
3 weeks on average for standard orders or 2 weeks on average for STAT orders.
Please note: Once the testing process begins, an Estimated Report Date (ERD) range will be displayed in the portal. This is the most accurate prediction of when your report will be complete and may differ from the average TAT published on our website. About 85% of our tests will be reported within or before the ERD range. We will notify you of significant delays or holds which will impact the ERD. Learn more about turnaround times here.
Targeted Testing
For ordering sequencing of targeted known variants, go to our Targeted Variants page.
Clinical Features and Genetics
Clinical Features
Oligodontia is a congenital condition in which six or more permanent teeth fail to develop (Matalova et al. J Dent Res 87:617-623, 2008; Coster et al. J Oral Pathol Med 38:1-17, 2009). Often, oligodontia is included as a symptom of a syndromic genetic disorder, as in the case of Charcot-Marie-Tooth or cleft lip/palate syndromes. However, oligodontia can also occur as an isolated condition (i.e. non-syndromic) without any other readily apparent symptoms. Several genes are known to be involved in oligodontia and tooth agenesis, including MSX1, PAX9, and AXIN2 (Nieminen et al. Eur J Hum Genet 9:743-746, 2001; Nieminen et al. J Dent Res 82:1013-1017, 2003; Mostowska et al. J Hum Genet 51:262-266, 2006). Importantly, variants in AXIN2 were also found to segregate with colorectal neoplasia (Lammi et al. Am J Hum Genet 74:1043-1050, 2004). In patients with AXIN2 variants, oligodontia presented at an early age when their permanent teeth failed to develop, whereas colorectal neoplasia developed much later, usually between the ages of 30 and 60. Accordingly, screening patients with non-syndromic oligodontia for variants in the AXIN2 gene can be an effective way to identify individuals with a risk of developing colorectal cancer later in life.
Genetics
Oligodontia-colorectal cancer (OMIM 608615) syndrome is inherited in an autosomal dominant fashion. Lammi et al. (2004) described a large, four-generation Finnish family in which nine family members presented with oligodontia. All nine were found to have a heterozygous nonsense variant (p.Arg656*) in the AXIN2 gene, while none of the family members with normal dentation had the variant. Importantly, six (67%) of the individuals with oligodontia also developed colorectal neoplasia by the age of 62. In addition to this family, the authors also screened AXIN2 in other patients with oligodontia and identified a heterozygous frameshift variant (p.Asn666Glnfs*40) in a 13 year old boy. Interestingly, the healthy parents of this boy were not found to have the variant, indicating it was de novo. In addition to these germline variants, several somatic frameshift variants in AXIN2 have been identified in colorectal tumors, further providing support for the role of AXIN2 in the development of cancer (Liu et al. Nat Genet 26:146-147, 2000).
Clinical Sensitivity - Sequencing with CNV PG-Select
The clinical sensitivity of this test is currently unknown.
Testing Strategy
This test provides full coverage of all coding exons of the AXIN2 gene, plus ~10 bases of flanking noncoding DNA. We define full coverage as >20X NGS reads or Sanger sequencing.
Indications for Test
Candidates for this test are patients with oligodontia. This test is specifically designed for heritable germline variants and is not appropriate for the detection of somatic variants in tumor tissue.
Candidates for this test are patients with oligodontia. This test is specifically designed for heritable germline variants and is not appropriate for the detection of somatic variants in tumor tissue.
Gene
| Official Gene Symbol | OMIM ID |
|---|---|
| AXIN2 | 604025 |
| Inheritance | Abbreviation |
|---|---|
| Autosomal Dominant | AD |
| Autosomal Recessive | AR |
| X-Linked | XL |
| Mitochondrial | MT |
Disease
| Name | Inheritance | OMIM ID |
|---|---|---|
| Oligodontia-Colorectal Cancer Syndrome | AD | 608615 |
Related Test
| Name |
|---|
| Colorectal Cancer Panel |
Citations
- De Coster, P. J., et.al. (2009). "Dental agenesis: genetic and clinical perspectives." J Oral Pathol Med 38(1): 1-17. PubMed ID: 18771513
- Lammi, L., et.al. (2004). "Mutations in AXIN2 cause familial tooth agenesis and predispose to colorectal cancer." Am J Hum Genet 74(5): 1043-50. PubMed ID: 15042511
- Liu, W., et.al. (2000). "Mutations in AXIN2 cause colorectal cancer with defective mismatch repair by activating beta-catenin/TCF signalling." Nat Genet 26(2): 146-7. PubMed ID: 11017067
- Matalova, E., et.al. (2008). "Tooth agenesis: from molecular genetics to molecular dentistry." J Dent Res 87(7): 617-23. PubMed ID: 18573979
- Mostowska, A., et.al. (2006). "Axis inhibition protein 2 (AXIN2) polymorphisms may be a risk factor for selective tooth agenesis." J Hum Genet 51(3): 262-6. PubMed ID: 16432638
- Nieminen, P., et.al. (2001). "Identification of a nonsense mutation in the PAX9 gene in molar oligodontia." Eur J Hum Genet 9(10): 743-6. PubMed ID: 11781684
- Nieminen, P., et.al. (2003). "MSX1 gene is deleted in Wolf-Hirschhorn syndrome patients with oligodontia." J Dent Res 82(12): 1013-7. PubMed ID: 14630905
Ordering/Specimens
Ordering Options
We offer several options when ordering sequencing tests. For more information on these options, see our Ordering Instructions page. To view available options, click on the Order Options button within the test description.
myPrevent - Online Ordering
- The test can be added to your online orders in the Summary and Pricing section.
- Once the test has been added log in to myPrevent to fill out an online requisition form.
- PGnome sequencing panels can be ordered via the myPrevent portal only at this time.
Requisition Form
- A completed requisition form must accompany all specimens.
- Billing information along with specimen and shipping instructions are within the requisition form.
- All testing must be ordered by a qualified healthcare provider.
For Requisition Forms, visit our Forms page
If ordering a Duo or Trio test, the proband and all comparator samples are required to initiate testing. If we do not receive all required samples for the test ordered within 21 days, we will convert the order to the most effective testing strategy with the samples available. Prior authorization and/or billing in place may be impacted by a change in test code.
Specimen Types
Specimen Requirements and Shipping Details
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ORDER OPTIONS
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2) Select Additional Test Options
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