Case Study

A 38-year-old male with long-segment Barrett’s esophagus and a low-risk TissueCypher emphasized the need to consider all the factors of the case.

“So to me, all those [clinical factors] point to a little bit higher risk. But then we combine that with the TissueCypher results of lower risk, and I think, here, we meet in the middle.”

See the case details below.

Case details

RELEVANT MEDICAL HISTORY
ADDITIONAL CONSIDERATIONS
  • No relevant family history
  • Mild obseity (BMI 33)
  • Chronic GERD for 20 years
  • PPI use - 20 years
  • Non-smoker
  • Non-dysplastic Barrett's since 2007
  • Laparoscopic Nissen 2014

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DecisionDx-SCC Case Studies
Case Study

A 38-year-old male with long-segment Barrett’s esophagus and a low-risk TissueCypher emphasized the need to consider all the factors of the case.

“So to me, all those [clinical factors] point to a little bit higher risk. But then we combine that with the TissueCypher results of lower risk, and I think, here, we meet in the middle.”

See the case details below.

Case details

RELEVANT MEDICAL HISTORY
ADDITIONAL CONSIDERATIONS
  • No relevant family history
  • Mild obseity (BMI 33)
  • Chronic GERD for 20 years
  • PPI use - 20 years
  • Non-smoker
  • Non-dysplastic Barrett's since 2007
  • Laparoscopic Nissen 2014

See other cases with Dr. Lipham

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DecisionDx-Melanoma Case Studies
Case Study

A 38-year-old male with long-segment Barrett’s esophagus and a low-risk TissueCypher emphasized the need to consider all the factors of the case.

“So to me, all those [clinical factors] point to a little bit higher risk. But then we combine that with the TissueCypher results of lower risk, and I think, here, we meet in the middle.”

See the case details below.

Case details

RELEVANT MEDICAL HISTORY
ADDITIONAL CONSIDERATIONS
  • No relevant family history
  • Mild obseity (BMI 33)
  • Chronic GERD for 20 years
  • PPI use - 20 years
  • Non-smoker
  • Non-dysplastic Barrett's since 2007
  • Laparoscopic Nissen 2014

See other cases with Dr. Lipham

View all cases

MyPath Melanoma Case Studies
Dr. John Lipham: Case 2

Long segment and TissueCypher low risk

A 38-year-old male with long-segment Barrett’s esophagus and a low-risk TissueCypher emphasized the need to consider all the factors of the case.

“So to me, all those [clinical factors] point to a little bit higher risk. But then we combine that with the TissueCypher results of lower risk, and I think, here, we meet in the middle.”

See the case details below.

Clinical risk factors

A 38-year-old male was scheduled for a surveillance endoscopy to check on his Barrett’s esophagus. He had previously suffered from chronic GERD, which was treated through PPIs and a laparoscopic Nissen procedure. He was mildly obese.

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RELEVANT MEDICAL HISTORY
  • No relevant family history
  • Mild obseity (BMI 33)
  • Chronic GERD for 20 years
  • PPI use - 20 years
  • Non-smoker
ADDITIONAL CONSIDERATIONS
  • Non-dysplastic Barrett's since 2007
  • Laparoscopic Nissen 2014

Endoscopic findings

During endoscopy, the Barrett’s esophagus segment length was measured at 4 cm, and the anti-reflux procedure was intact, but loosened. Pathology returned non-dysplastic.

Lower esophagus:
  • Barrett's segment length: 4 cm
  • Nissen with wrap intact
  • GE flap Hill Grade II
  • 1 cm paraesophageal hernia
  • LA Grade A esophagitis in the distal esophagus
  • Pathology returned non-dysplastic
Traditional Management:
  • Clinical profile: Low risk
  • Treatment recommendation: 3-year surveillance

TissueCypher results

Receiving a low-risk TissueCypher score, Dr. Lipham weighed those results against the clinical risk factors and felt comfortable keeping the existing 3-year surveillance interval.

  • Risk class: Low
  • Risk score: 3.9
  • 5-year risk of progression: 3%

TissueCypher-guided management

  • Continue 3-year surveillance

"So to me, all those [clinical factors] point to a little bit higher risk. But then we combine that with the TissueCypher results of lower risk, and I think, here, we meet in the middle."

John C. Lipham, MD

See other cases with Dr. Lipham