Case Study

A 77-year-old white male visited Dr. Lipham for a surveillance endoscopy. In the past, this patient had chronic GERD that had become controlled via PPIs and an anti-reflux procedure. But while the patient’s clinical risk factors suggested low risk, TissueCypher results returned high risk.

“This guy probably would have been lost to follow-up, but because of this [TissueCypher] result we talked to him about ablation of his Barrett’s ,” says Lipham.

See the case details below.

Case details

RELEVANT MEDICAL HISTORY
ADDITIONAL CONSIDERATIONS
  • No relevant family history
  • BMI 26
  • Chronic GERD for 25+ years
  • PPI use - 20 years, Nexium
  • No smoking history
  • History of non-dysplastic Barrett's since 2015
  • Underwent LINX anti-reflux procedure 2/2020 to control reflux

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DecisionDx-SCC Case Studies
Case Study

A 77-year-old white male visited Dr. Lipham for a surveillance endoscopy. In the past, this patient had chronic GERD that had become controlled via PPIs and an anti-reflux procedure. But while the patient’s clinical risk factors suggested low risk, TissueCypher results returned high risk.

“This guy probably would have been lost to follow-up, but because of this [TissueCypher] result we talked to him about ablation of his Barrett’s ,” says Lipham.

See the case details below.

Case details

RELEVANT MEDICAL HISTORY
ADDITIONAL CONSIDERATIONS
  • No relevant family history
  • BMI 26
  • Chronic GERD for 25+ years
  • PPI use - 20 years, Nexium
  • No smoking history
  • History of non-dysplastic Barrett's since 2015
  • Underwent LINX anti-reflux procedure 2/2020 to control reflux

See other cases with Dr. Lipham

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DecisionDx-Melanoma Case Studies
Case Study

A 77-year-old white male visited Dr. Lipham for a surveillance endoscopy. In the past, this patient had chronic GERD that had become controlled via PPIs and an anti-reflux procedure. But while the patient’s clinical risk factors suggested low risk, TissueCypher results returned high risk.

“This guy probably would have been lost to follow-up, but because of this [TissueCypher] result we talked to him about ablation of his Barrett’s ,” says Lipham.

See the case details below.

Case details

RELEVANT MEDICAL HISTORY
ADDITIONAL CONSIDERATIONS
  • No relevant family history
  • BMI 26
  • Chronic GERD for 25+ years
  • PPI use - 20 years, Nexium
  • No smoking history
  • History of non-dysplastic Barrett's since 2015
  • Underwent LINX anti-reflux procedure 2/2020 to control reflux

See other cases with Dr. Lipham

View all cases

MyPath Melanoma Case Studies
Dr. John Lipham: Case 1

Short segment and TissueCypher high risk

A 77-year-old white male visited Dr. Lipham for a surveillance endoscopy. In the past, this patient had chronic GERD that had become controlled via PPIs and an anti-reflux procedure. But while the patient’s clinical risk factors suggested low risk, TissueCypher results returned high risk.

“This guy probably would have been lost to follow-up, but because of this [TissueCypher] result we talked to him about ablation of his Barrett’s ,” says Lipham.

See the case details below.

Clinical risk factors

A 77-year-old male patient was diagnosed with non-dysplastic Barrett’s esophagus in 2015 and underwent a LINX anti-reflux procedure in 2020. He was returning to Dr. Lipham for routine surveillance.

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RELEVANT MEDICAL HISTORY
  • No relevant family history
  • BMI 26
  • Chronic GERD for 25+ years
  • PPI use - 20 years, Nexium
  • No smoking history
ADDITIONAL CONSIDERATIONS
  • History of non-dysplastic Barrett's since 2015
  • Underwent LINX anti-reflux procedure 2/2020 to control reflux

Endoscopic findings

The endoscopy confirmed the presence of short-segment Barrett's esophagus, but nothing suggested a high risk of progression.

Lower esophagus:
  • Barrett's segment length: 1 cm at 36 cm
  • Linx device at GE junction
  • GE flap Hill Grade II
  • No hiatal hernia
  • Pathology returned non-dysplastic
Traditional Management:
  • Clinical profile: Low risk
  • Treatment recommendation: 5-year surveillance

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TissueCypher results

TissueCypher test results indicated a very high 5-year probability of progression (36%). Given this new information, Dr. Lipham offered the patient endoscopic eradication therapy, and his Barrett’s esophagus was successfully eradicated in 2 sessions.

  • Risk class: High
  • Risk score: 8.5
  • 5-year risk of progression: 36%

TissueCypher-guided management

  • Upstaged to endoscopic eradication therapy

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"This guy probably would have been lost to follow-up, but because of this [TissueCypher] result we talked to him about ablation of his Barrett's."

John C. Lipham, MD

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