Review for 10.1186/1471-230X-12-77 (2012)

Reviewer's report
Title:Immunophenotype classification and therapeutic outcomes of Chinese
primary gastrointestinal diffuse large B-cell lymphoma
Version: 2Date:14 May 2012
Reviewer: Russell Ryan
Reviewer's report:
Review of “Immunophenotype classification and therapeutic outcomes of
Chinese primary gastrointestinal diffuse large B-cell lymphoma” by Zhang et al.
General comments:
This is a good, focused study on an uncommon lymphoma subgroup. With the
bellow issues addessed, this paper would make a useful contribution to the
literature on this topic.
Major compulsory revisions:
Page 11: “The study on the relationship between immunophenotype classification
and pathological parameters indicated that the size of a GCB tumor was larger
than that of a non-GCB tumor…” This is the opposite of the relationship stated in
the Results (page 7)
Minor essential revisions:
Page 6: Under “Classification of DLBCL”: The Hans algorithm is well summarized
by the diagram, and does not need to be written out here. However, it is
important to state the percentage of tumor cells that needed to stain for each
marker in order to call the case positive – BCL6 and MUM1 in particular are often
heterogeneously expressed.
Page 10. “The third type, DLBCL co-express GCB and ABC DLBCL,
is referred to as type 3. The type 3 group is heterogeneous and not well defined,
but
has a poor outcome similar to the ABC group.” – This statement is unclear as
written, and should be clarified with a specific reference. Multiple “third groups”
have been reported in different studies, including some studies which showed a
gene expression group intermediate between ABC and GCB, and other studies
which have shown a unique expression signature for primary mediastinal large B
cell lymphoma.
It is assumed that the patients in this study were not randomized to treatment as
part of a clinical trial, so the statements regarding survival in association with
different therapy (no chemo, CHOP, R-CHOP) should include caveats about
possible confounding factors, such as older or sicker patients not being
candidates for chemotherapy. The reasons that some patients were treated with
CHOP, and others with R-CHOP should be summarized for the reader.
Discretionary revisions:
Page 5: I haven’t heard “ventricular” used commonly in this way. Perhaps “gastric
corpora”, “gastric fundus” etc. would be clearer terminology
Page 7: “And there was a
significant difference between the two subtypes (#2=6.403#P<0.05)” –
Incomplete sentence
Page 9: The term “expression microarray” may be preferable to “cDNA
microarray”, since not all microarrays used for this classification employ cDNA.
Page 10: “The study by Hans et al [1] showed that the 5-year overall survival rate
for the GCB group is more than 70%, which is obviously higher than the ABC and
type 3 groups.” – Omit the word “obviously”.
Page 11: “…while the two subtypes did nothing with infiltrate depth.” Unclear
statement. Do the authors mean ‘while the two subtypes did not differ with
respect to average depth of infiltration.’
Page 11: “Our study also showed that the survival rate of patients in the GCB
group was
obviously longer than that of patients in non-GCB group” – Omit ‘obviously’
Page 12: “And in the non-GCB group, the survival rate
of patients treated with R-CHOP was significantly longer than those with CHOP.
In
the GCB group, R-CHOP chemotherapy also seemed to be an advantage (5
patients
receiving R-CHOP chemotherapy survived). But it was not found to be
statistically
significant between patients receiving R-CHOP and CHOP therapy.” – These are
both incomplete sentences.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
'I declare that I have no competing interests