Review for 10.1186/s12876-020-01484-9 (2020)

Reviewer’s report
Title: 
Expression and significance of Her2 and Ki-67 in gastric adenocarcinoma
without distant metastasis: A cohort study
Version: 
0 
Date: 
20 May 2020
Reviewer's report:
The authors in this study have investigated the expression and significance of
hHer2 and Ki657 expression in gastric adenocarcinoma (GaC) without
metastasis. 
Resection specimen was examined for Her2 and Ki67 by
immunohistochemistry; the combinations of expression of these proteins were
correlated with different stages of GaC. The authors conclude that the combined
expression of Her2 and Ki67 is associated with differentiation and pTNM stage
in non-metastatic Gac, especially node-negative disease. 
They also conclude that
combined expression is associated with less advanced pT stage, but a more
advanced pN stage. 
This is a poorly written manuscript, which makes it
extremely difficult to assess this study's merit. 
Therefore, the advancement of
knowledge in the field is unclear.
Major concerns
1. The manuscript is tough to read. The organization od results and the
presentation style make it had to assess the outcome of the study. 
It is hard to
determine whether their conclusions can be supported by the data presented. 
I
have read this manuscript three times but failed to make sense of the outcome. 
2. Many abbreviations have been used without any explanation of what they are.
The stages, such as PTNM, pT, and pN are not described anywhere. 
It is unclear
what they are and their significance.
3. While the immunohistochemistry is quantitative, it is also as clear as negative
and positive. 
If the positive, the level of expression of these proteins may be
different at different stages. 
This is not taken into consideration. 
For example, the
data in Table 2, particularly the comparison of 3 stages of pTNM, are not as
clear as it is concluded in this manuscript. 
Some method of quantification of the
expression is needed, and the ratio of expression of these two proteins may be a
better indicator than negative vs. positive expression.
4. The authors report that Her2 is localized in membrane and cytosol. 
It is
challenging to make that conclusion from the immunohistochemistry images,
particularly one that is presented in Figure 1.
5. It is not clear what +, ++, +++ represent in figure 1. 
I think it is important to
provide representative images from tumors at different pTNM stages.
6. Nomograms are not described well anywhere in the manuscript. 
I could not
determine what the results of this study conveyed from these nomograms.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
Yes
Does the work include the necessary controls?
If not, please specify which controls are required in your comments to the
authors.
Yes
Are the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
Unable to assess
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional statistical review is recommended, please specify what aspects
require further assessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
Not suitable for publication unless extensively edited
Declaration of competing interests
Please complete a declaration of competing interests, considering the following
questions:
1
. 
Have you in the past five years received reimbursements, fees, funding, or
salary from an organisation that may in any way gain or lose financially
from the publication of this manuscript, either now or in the future?
2
. 
Do you hold any stocks or shares in an organisation that may in any way
gain or lose financially from the publication of this manuscript, either now
or in the future?
3
. 
Do you hold or are you currently applying for any patents relating to the
content of the manuscript?
4
. 
Have you received reimbursements, fees, funding, or salary from an
organization that holds or has applied for patents relating to the content of
the manuscript?
5
. 
Do you have any other financial competing interests?
6
. 
Do you have any non-financial competing interests in relation to this
paper?
If you can answer no to all of the above, write 'I declare that I have no competing
interests' below. If your reply is yes to any, please give details below.
I declare that I have no competing interests.
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