Review for 10.1186/s12876-020-01590-8 (2021)

Reviewer’s report
Title: 
Utility of a 21-gauge Menghini-type biopsy needle with rolling method for an endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study
Version: 
0 
Date: 
16 Oct 2020
Reviewer: 
Takeshi Hisa
Reviewer's report:
The authors describes that the 21-gauge Menghini-type biopsy needle was useful for endoscopic
ultrasound-guided histological diagnosis of autoimmune pancreatitis compared with the conventional 22-
gauge or 19-gauge needles. This article is interesting; however, there are several problems.
Major: 
1. What enable abundant acquisition of tissue by the 21-gauge Menghini-type needle compared with the
conventional 22-gauge needles? 
The rolling method seems to have considerable effect rather than the
needle shape and system.
2. In the historical control, the 19-gauge needle should be excluded due to the use only in 2 procedures.
3. In this study, the histological diagnostic rate of AIP by the conventional 22-gauge needles is very low
compared with that in the previous reports. You should state the reasons in detail.
4. Ease of puncture depends on the scope position. Amount of acquired tissue seems to depend on the
funning method and the stroke length of needle. These factors should be mentioned.
5. In four patients who improved before steroid treatment in the conventional needle group, AIP could
have resolved at the time of FNA. If it is so, the histological diagnostic rate should become lower.
Minor:
1. Did you use the EUS Sonopsy CY (HAKKO Medical)? If it is so, you should state it in the materials
and methods.
2. Figure 3 is similar to Figure 4. One figure contains different information of the 21-gauge Menghini-
type needle and the conventional 22-gauge needle. It is difficult for the audience to understand. You
should show the figures simply. 
Example) Fig. 3. Case of using the 21-gauge Menghini-type needle, Fig. 4. Case of using the conventional
22-gauge needle
3. In this study, you emphasize the acquisition of good-quality tissue to diagnose as AIP definitely. You
should show histopathological images of the storiform fibrosis and the obliterative phlebitis also.
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Is the study design appropriate to answer the research question (including the use of appropriate controls),
and are the conclusions supported by the evidence presented?
Yes
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Yes
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Yes
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Yes
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manipulation?
Yes