Loewe Case Study 2 | TissueCypher

Anxiety from a family history of esophageal adenocarcinoma

This case involves a 68-year-old male patient with long-segment non-dysplastic Barrett’s esophagus and high anxiety stemming from the loss of his brother to esophageal adenocarcinoma.

“TissueCypher helped us to reassure [the patient] that he was making the right decision, lowered his anxiety, and gave him a high confidence level”

Clinical risk factors

68-year-old, white male

A 68-year-old male patient with a 30-year history of GERD and high anxiety secondary to his brother who has esophageal adenocarcinoma (EAC) without having any prior symptoms of GERD.

RELEVANT MEDICAL HISTORY
- BMI 28 (overweight)
- Chronic GERD for 30 years
- Daily PPI: Rabeprazole 40 mg
- Non-smoker
ADDITIONAL CONSIDERATIONS
- Brother has EAC (T3N1Mx)
- Has been in surveillance program for NDBE every 3-5 years

Endoscopic findings

The endoscopy confirmed the presence of long-segment non-dysplasatic Barrett's esophagus by both traditional pathology and WATS^3D.

Lower esophagus:

BE segment: C3M3
2 cm hiatal hernia
Non-dysplastic pathology
WATS^3D-confirmed NDBE

Traditional Management:

Clinical profile: High risk due to family history
Treatment recommendation: 1-year surveillance or Endoscopic Eradication Therapy (EET)

From top left to bottom left: Middle third of esophagus, Gastroesophageal junction, lower third of esophagus

TissueCypher results

Dr. Loewe and the patient were considering short interval surveillance or eradication therapy. The high-risk TissueCypher result tipped the scales in favor of proceeding to EET.

Risk class: High
Risk score: 6.4
5-year risk of progression: 12%

TissueCypher-guided management