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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.
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
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
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Upstaged to endoscopic eradication therapy
"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