EPCAM

Chr 2ARAD

epithelial cell adhesion molecule

Also known as: Ber-Ep4, BerEp4, DIAR5, EGP-2, EGP314, EGP40, ESA, HNPCC8

The EPCAM protein functions as a homotypic calcium-independent cell adhesion molecule expressed on epithelial cells and may provide immunological barrier function between intestinal epithelial cells and intraepithelial lymphocytes. Mutations cause congenital tufting enteropathy with severe diarrhea presenting in infancy, inherited in an autosomal recessive pattern, and Lynch syndrome 8, inherited in an autosomal dominant pattern. The gene shows tolerance to loss-of-function variants (LOEUF 1.159), suggesting different pathogenic mechanisms may underlie these distinct clinical presentations.

Summary from RefSeq, OMIM, UniProt
Research Assistant →

Primary Disease Associations & Inheritance

Diarrhea 5, with tufting enteropathy, congenitalMIM #613217
AR
Lynch syndrome 8MIM #613244
AD
12
Active trials
416
Pubs (1 yr)
46
P/LP submissions
0%
P/LP missense
1.16
LOEUF
LOF
Mechanism· G2P
Clinical SummaryEPCAM
🧬
Gene-Disease Validity (ClinGen)
Lynch syndrome · ADDefinitive

Definitive — sufficient evidence for diagnostic panels

2 total gene-disease associations curated

Population Constraint (gnomAD)
Low constraint (pLI 0.00) — loss-of-function variants are relatively tolerated in the population.
📋
ClinVar Variants
45 unique Pathogenic / Likely Pathogenic· 312 VUS of 500 total submissions
💊
Clinical Trials
12 active or recruiting trials — potential therapeutic options may be available
📖
GeneReview available — EPCAM
Authoritative clinical overview · Recommended first read
Open GeneReview ↗

Population Genetics & Constraint

gnomAD v4 — loss-of-function & missense intolerance

Tolerant — LoF & missense variants common in population
LoF Constraint
1.16LOEUF
pLI 0.000
Z-score 1.06
OE 0.73 (0.471.16)
Tolerant

Highly tolerant — LoF variants common in population

Missense Constraint
-1.43Z-score
OE missense 1.31 (1.171.47)
219 obs / 167.0 exp
Tolerant

Tolerant to missense variation

Observed / Expected Ratios
LoF OE0.73 (0.471.16)
00.351.4
Missense OE1.31 (1.171.47)
00.61.4
Synonymous OE1.27
01.21.6
LoF obs/exp: 13 / 17.8Missense obs/exp: 219 / 167.0Syn Z: -1.65
Curated Mechanism (G2P)Gene2Phenotype (DDG2P) ↗
definitiveEPCAM-related colorectal cancer, hereditary nonpolyposisLOFAD
definitiveEPCAM-related diarrhea with tufting enteropathy, congenitalLOFAR
DN
0.6840th %ile
GOF
0.6052th %ile
LOF
0.2580th %ile

The highest-scoring mechanism for this gene is dominant-negative.

DNprediction above median

Note: In-silico variant effect predictors (SIFT, PolyPhen, REVEL, CADD) may underestimate pathogenicity of missense variants in genes with GOF or DN mechanisms. Consider functional evidence and clinical context.

Predictions from Badonyi M, Marsh JA. PLoS ONE. 2024;19(8):e0307312.

ClinVar Variant Classifications

500 submitted variants in ClinVar

Classification Summary

Pathogenic34
Likely Pathogenic11
VUS312
Likely Benign125
Conflicting2
34
Pathogenic
11
Likely Pathogenic
312
VUS
125
Likely Benign
2
Conflicting

Curated Variants Distribution

Classified variants from ClinVar · 5 ACMG categories

ClassificationLoFMissense + InframeNon-codingSynonymousTotal
Pathogenic
6
0
28
0
34
Likely Pathogenic
4
0
7
0
11
VUS
1
295
16
0
312
Likely Benign
0
9
9
107
125
Benign
0
0
0
0
0
Conflicting
2
Total1130460107484

LoF = frameshift, stop gained/lost, canonical splice · Counts from ClinVar esearch · Updated hourly

View in ClinVar →

Protein Context — Lollipop Plot

EPCAM · protein map & ClinVar variants

Showing all ClinVar variants across the protein. Search a specific variant to highlight its position.

Clinical Trials

Active and recruiting trials from ClinicalTrials.gov

Lynch SyndromeLynch Syndrome ILynch Syndrome II

Videocapsule Endoscopy in Lynch Syndrome

RECRUITING
NCT05704010Phase NASan Raffaele UniversityStarted 2018-11-01
Video capsule endoscopy
Menstruation

Evolutive and Functional Bases of Menstruation in Women - 2

RECRUITING
NCT05412771Phase NAInstitut National de la Santé Et de la Recherche Médicale, FranceStarted 2022-11-23
Hysteroscopy
Lynch SyndromeEndometrial Cancer

EC_ItaLynch: Mainstreaming the Diagnosis of Lynch Syndrome

NOT YET RECRUITING
NCT06501417Fondazione Policlinico Universitario Agostino Gemelli IRCCSStarted 2024-08-01
mainstreaming
Pancreas CancerPancreas CystPancreatic Ductal Adenocarcinoma

Pancreatic Cancer Early Detection Consortium

RECRUITING
NCT04970056Arbor Research Collaborative for HealthStarted 2020-09-18
Crohn Disease

Unveiling the Microbial Impact on Intestinal Fibrosis

NOT YET RECRUITING
NCT06073288IRCCS San RaffaeleStarted 2023-11-01
Surgical specimens of CD and no-IBD patients
Hereditary Breast/Ovarian Cancer (brca1, brca2)Lynch SyndromeGenetic Variation

Patient Centered Clinical Decision Support for Hereditary Cancer Syndromes

ENROLLING BY INVITATION
NCT06914726Phase NAHealthPartners InstituteStarted 2025-07-09
Patient Centered Clinical Decision Support (PC-CDS)
Lynch SyndromeLynch Syndrome ILynch Syndrome II

Lynch Syndrome X-Talk of Enteral Mucosa With Immune System

RECRUITING
NCT06708429San Raffaele UniversityStarted 2023-06-01
LYNX EYE (Lynch syndrome X-Talk of Enteral mucosa with Immune System)
Pancreas CancerExosomesExtracellular Vesicles

ExoLuminate Study for Early Detection of Pancreatic Cancer

RECRUITING
NCT05625529Biological DynamicsStarted 2022-12-19
Crohn Disease (CD)

The Microbial Impact on Intestinal Fibrosis and the Associated Immune Microenvironment in Crohn's Disease

NOT YET RECRUITING
NCT06720961IRCCS San RaffaeleStarted 2025-04
Collection of surgical specimenCollection of stool sample
Prostate Cancer

Analysing Outcomes After Prostate Cancer Diagnosis and Treatment in Carriers of Rare Germline Mutations

RECRUITING
NCT02705846Institute of Cancer Research, United KingdomStarted 2014-09
Observation of treatment outcomes via Questionnaire
Solid TumorAdvanced Solid TumorMetastatic Cancer

KPMNG Study of MOlecular Profiling Guided Therapy Based on Genomic Alterations in Advanced Solid Tumors II

RECRUITING
NCT05525858Seoul National University Bundang HospitalStarted 2022-09-28
AlectinibAtezolizumabErlotinib
BRCA-Mutated Ovarian CarcinomaBRIP1 Gene MutationMSH2 A636P

Cascade Testing in Families With Newly Diagnosed Hereditary Breast and Ovarian Cancer Syndrome

ACTIVE NOT RECRUITING
NCT04009148NYU Langone HealthStarted 2019-03-01
CASCADE genetic screening
Clinical Literature
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