JerMa88/BMC_Gastroenterology_Peer_Reviews huggingface dataset:
Review for 10.1186/s12876-023-02828-x (2023)

Title: Preoperative Platelet-Lymphocyte Ratio (PLR) as a Prognostic Inflammation Biomarker
in Asian HIV-Infected Patients with Gastric Cancer: A Single-Center Study
Version: 3 Date: 01 Apr 2023
Reviewer's report:
"PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Not sure - I am not able to assess the statistics in this study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
No - there are minor issues
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Yes - current version is technically sound
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: The authors present a retrospective study to evaluate the prognostic
value of preoperative systemic inflammation biomarkers in Asian HIV-infected patients with
gastric cancer (GC). The study included 41 HIV-infected GC patients who underwent surgery
at the Shanghai Public Health Clinical Center, and 127 GC patients without HIV infection. The
preoperative platelet to lymphocyte ratio (PLR) was measured and patients were divided into two
groups based on the optimal cut-off value. The study found that HIV-infected GC patients had
worse clinical outcomes than the normal GC population. Multivariate Cox regression analysis
revealed that a low PLR was an independent predictor of better overall survival (OS) and
progression-free survival (PFS).
This is a single institute study, and the patient numbers are limited to draw any conclusion.
Also, reviewer 2 pointed out that the authors mentioned CRC (colorectal cancer ) instead of
GC. Although the authors have made the changes in the revised text, there is a question about
the authenticity of the study and the data presented. The authors have responded to the review
comments but did not validate their findings in an independent cohort.
REQUESTED REVISIONS:
The claims in the study are based on single institution and small patient numbers. The results
need to be validated in an independent cohort of GC patients."
Review for 10.1186/s12876-023-02828-x (2023)

Title: Preoperative Platelet-Lymphocyte Ratio (PLR) as a Prognostic Inflammation Biomarker
in Asian HIV-Infected Patients with Gastric Cancer: A Single-Center Study
Version: 4 Date: 04 May 2023
Reviewer's report:
PEER REVIEWER ASSESSMENTS:
OBJECTIVE - Full research articles: is there a clear objective that addresses one or several
testable research questions? (Brief or other article types: is there a clear objective?)
Yes - there is a clear objective
DESIGN - Is the current approach (including controls and analysis protocols) appropriate for
the objective?
Yes - the approach is appropriate
EXECUTION - Are the experiments and analyses performed with sufficient technical rigor to
allow confidence in the results?
Yes - experiments and analyses were performed appropriately
STATISTICS - Is the use of statistics in the manuscript appropriate?
Not sure - I am not able to assess the statistics in this study
INTERPRETATION - Is the current interpretation/discussion of the results reasonable and not
overstated?
Yes - the author's interpretation is reasonable
OVERALL MANUSCRIPT POTENTIAL - Has the author addressed your concerns sufficiently
for you to now recommend the work as a technically sound contribution? If not, can further
revisions be made to make the work technically sound?
Probably - with minor revisions
PEER REVIEWER COMMENTS:
GENERAL COMMENTS: As a critique, while the authors have made efforts to address previous
review comments, the lack of validation using an independent cohort remains a significant
limitation of this study. This leaves room for potential biases and calls into question the reliability
of the results.
Additionally, the challenges of studying a rare condition such as HIV infection are
acknowledged by the authors but are not adequately highlighted in the revised manuscript. It is
essential to acknowledge the study's limitations, including the limited sample size and potential
for selection bias, which may impact the generalizability of the findings.
It is recommended that the authors list and discuss the limitations of their study to provide a
more balanced interpretation of the results. This will help readers to better understand the scope
and potential impact of the research.
REQUESTED REVISIONS:
The lack of validation using an independent cohort remains a significant limitation of this study.
It is important to acknowledge the limitations of the study, including the limited sample size and
potential for selection bias, which may impact the generalizability of the findings.
It is recommended that the authors clearly list and discuss the limitations of their study in order to
provide a more balanced interpretation of the results. This will help readers to better understand
the scope and potential impact of this single institution-based study.
Review for 10.1186/s12876-023-02826-z (2023)

Title: Oxidative balance score and dietary phytochemical index can reduce the risk of colorectal
cancer in Iranian population
Version: 0 Date: 15 Mar 2023
Reviewer's report:
This is a well-designed case-control study, and does add something new to the field. However,
there are some closure issues that should be addressed.
1. How did you calculate the sample size? Please add the related section to the methods.
2. There are several English errors in the manuscript, for example: line 51, line 52, line 79-80,
line 175-178, ...
3. Please add the flowchart of the study to the manuscript.
4. In methods, line 109-110, why did you exclude the patients from the study? Is there any
exclusion criteria in your study protocols? Explain them.
5. In background of abstract, lack of similar studies was mentioned several times!
6. In methods of abstract, the authors mentioned: “Then, dietary indices were calculated by food
group intake”, whereas the OBS score does not based on food group.
Review for 10.1186/s12876-023-02826-z (2023)

Title: Oxidative balance score and dietary phytochemical index can reduce the risk of colorectal
cancer in Iranian population
Version: 0 Date: 10 Apr 2023
Reviewer:  Anwar Ali
Reviewer's report:
Although the article is good and the research has been drawn very well from authors but there
are still major issues which should be minimized before further process.
1. Abstract can be improved
2. Try to add some updated references in the background portion.
3. I have suggested some references below for the background section:
a: Manzoor, M. F., Arif, Z., Kabir, A., Mehmood, I., Munir, D., Razzaq, A., ... & Rusu, A.
(2022). Oxidative stress and metabolic diseases: Relevance and therapeutic strategies. Frontiers
in Nutrition, 9, 994309-994309.
b: Ali, A., Riaz, S., Sameen, A., Naumovski, N., Iqbal, M. W., Rehman, A., ... & Manzoor, M. F.
(2022). The disposition of bioactive compounds from fruit waste, their extraction, and analysis
using novel technologies: A review. Processes, 10(10), 2014.
c: Ali, A., Kousar, S., Khalid, W., Maqbool, Z., Aziz, A., Arshad, M. S., ... & Manzoor, M.
F. (2022). Crocin: Functional characteristics, extraction, food applications and efficacy against
brain related disorders. Frontiers in Nutrition, 3015.
d : Ali, A., Manzoor, M. F., Ahmad, N., Aadil, R. M., Qin, H., Siddique, R., ... & Aizhong,
L. (2022). The burden of cancer, government strategic policies, and challenges in Pakistan: A
comprehensive review. Frontiers in Nutrition, 1553.
4: I am a little bit confused about the dietary assessment of this research as there is no sufficient
data available within the  manuscript about it.
5: Discussion portion is not clear.
6: Conclusion is too short and you should put the future research direction too.
7: English grammar of this article is very poor, try to improve.
Review for 10.1186/s12876-023-02788-2 (2023)

Title: A single-center prospective study evaluating the usefulness of artificial intelligence for
the diagnosis of esophageal squamous cell carcinoma in a real-time setting
Version: 1 Date: 23 Mar 2023
Reviewer:  Atsushi Imagawa
Reviewer's report:
This study is to evaluate the usefulness of an AI system for real-time diagnosis of esophageal
squamous cell carcinoma (ESCC) in a clinical setting. This study is a clinical study with negative
results. However, the design and method of this study is fine and excellent. Furthermore, the
study results are very interesting, indicating the problems with endoscopic diagnosis by AI at
the current stage. There were a few points that were a little confusing, so I think corrections and
additional descriptions would be desirable.
Minor points
1#Determination of Sample Size
The pre-assumed frequency of target lesions was 46% (160/350), but the actual frequency was
62% (237/380).
Is this due to a different patients or situation from the previous study? Or as you describe in
the discussion, does the difference in frequency of cancer affect the difference in frequency of
target lesions?
Do you have any considerations?
If you have additional comments, please add them.
2. Is there any factor such as peristalsis of the esophagus, presence of mucus, patient's reflexes,
etc. that may have contributed to the poor accuracy of the AI systems in this result in the real-
time endoscopic procedure?
3. If possible, please add discussions of the results of the subgroup analysis. For example, why
is the accuracy inferior by -10% with AI systems for lesions larger than 10mm?
Review for 10.1186/s12876-023-02788-2 (2023)

Title: A single-center prospective study evaluating the usefulness of artificial intelligence for
the diagnosis of esophageal squamous cell carcinoma in a real-time setting
Version: 2 Date: 17 Apr 2023
Reviewer:  Ippei Tanaka
Reviewer's report:
Thank you for your detailed and honest answers to my questions. I apologize that a few of my
questions were due to my misunderstanding of your research. However, your accurate answers
allowed me to understand your paper in detail and I hope this interaction would have improved
the quality of this paper. I have nothing additional to ask you regarding this study as the authors
completely answered to my questions. I believe this article is worthy of acceptance in this
journal.
Review for 10.1186/s12876-023-02788-2 (2023)

Title: A single-center prospective study evaluating the usefulness of artificial intelligence for
the diagnosis of esophageal squamous cell carcinoma in a real-time setting
Version: 2 Date: 25 Apr 2023
Reviewer:  Atsushi Imagawa
Reviewer's report:
After reading the revise article, I would like to make the following comments.
The authors responded to all questions and issues I pointed out in detail. Therefore, I understood
them very well. This article is a valuable study of the limitations of real-time diagnosis of
esophageal squamous cell carcinoma using AI system.
Review for 10.1186/s12876-023-02793-5 (2023)

Title: ECONOMIC EVALUATIONS OF RADIOEMBOLIZATION WITH YTTRIUM-90
MICROSPHERES IN LIVER METASTASES OF COLORECTAL CANCER: A
SYSTEMATIC REVIEW
Version: 0 Date: 05 Feb 2023
Reviewer's report:
Nice research paper, the Authors clearly master the topic and the methodology.
We are nevertheless surprised - and need clarifications on 2 points
1) we missed the PROPSERO registration number. The registration of any systematic review,
with or without metanalysis, should be obtained.
2) neither forrest plots nor any other meta-analysis were provided for this SR. The reader struggle
to catch easily the conclusio of each comparison. Moreover, gicen the presence of clear groups
being compared with measurable effects, forrest plots could be generated. We strongly invite
the authors to provide graphical representation of each comparison, to increase fruibility of the
manuscript.
Review for 10.1186/s12876-023-02793-5 (2023)

Title: ECONOMIC EVALUATIONS OF RADIOEMBOLIZATION WITH YTTRIUM-90
MICROSPHERES IN LIVER METASTASES OF COLORECTAL CANCER: A
SYSTEMATIC REVIEW
Version: 0 Date: 02 Mar 2023
Reviewer's report:
I think that this review is well done and can be published as it is
Review for 10.1186/s12876-023-02793-5 (2023)

Title: ECONOMIC EVALUATIONS OF RADIOEMBOLIZATION WITH YTTRIUM-90
MICROSPHERES IN LIVER METASTASES OF COLORECTAL CANCER: A
SYSTEMATIC REVIEW
Version: 2 Date: 22 Apr 2023
Reviewer's report:
The authors have responded sufficiently to the reviewer's comments.
I appreciate your edits and the additional information asked for.
Review for 10.1186/s12876-023-02771-x (2023)

Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 1 Date: 30 Dec 2022
Reviewer's report:
Ref: Submission ID 524eff8e-6a96-4340-995a-b865a21e8094
Title:
"Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection in
Undifferentiated-type Early Gastric Cancer"
The authors examined a relatively large set of undifferentiated-type early gastric cancer and
revealed that LNM occurred in 69 of 346 patients (19.94%).  I believe the paper will potentially
be of interest to the readership of BMC Gastroenterology and may be acceptable after the points
listed below are addressed.
1. When discussing the potential risk of lymph node metastasis, it is recommended that eCura
system be mentioned.
Hatta W, Gotoda T, Oyama T, Kawata N, Takahashi A, Yoshifuku Y, Hoteya S, Nakagawa
M, Hirano M, Esaki M, Matsuda M, Ohnita K, Yamanouchi K, Yoshida M, Dohi O, Takada
J, Tanaka K, Yamada S, Tsuji T, Ito H, Hayashi Y, Nakaya N, Nakamura T, Shimosegawa
T. A Scoring System to Stratify Curability after Endoscopic Submucosal Dissection for Early
Gastric Cancer: "eCura system". Am J Gastroenterol. 2017 Jun;112(6):874-881. doi: 10.1038/
ajg.2017.95. Epub 2017 Apr 11. Erratum in: Am J Gastroenterol. 2019 Dec;114(12):1925-1926.
PMID: 28397873.
2. Although the following paragraph appear under the subheading "Risk of exceeding the ESD
expanded indications in UEGC," the content does not match the subheading: Further analysis
showed that three cases (4.10%) in the ESD indications group still had LNM, including two
cases invading the M but not the SM; the clinicopathological features are listed in Table 4. All
lesions were flat, two were cases of por mixed with mucinous components, and the other was a
case of pure muc. Notably, the largest diameter in all three lesions was 2.0 cm, which may be a
specific feature to differentiate from lymph node-negative patients.
3. In the Abstract, the term "submucosal tumors" should be revised, since "submucosal tumors"
generally indicate subepithelial lesions, rather than tumors invating into the submucosal layer.
4. In Table 3., the styles of "Smoking" and "Drinking" should be same as that of "Ulcer."
5. It is recommended that the number of patients with undifferentiated-type early gastric cancer
who underwent ESD during the study period (between January 2014 and December 2021) be
described, because it results in overestimation of the rate of LNM.
Review for 10.1186/s12876-023-02771-x (2023)

Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 1 Date: 01 Jan 2023
Reviewer's report:
This study evaluated risk of LNM and feasibility of ESD for UEGC. Although the theme is
interesting, several concerns can be raised.
Major
1. Preoperative and postoperative submucosal invasion are different. Indeed, previous reports
showed that the accuracy of preoperative diagnosis of submucosal invasion is 70-80%. How did
the authors differentiate preoperative submucosal invasion from postoperative one?
2. The same is true in ulceration and tumor size.
3. When the authors differentiated preoperative from postoperative diagnosis, please show the
relationship as a table.
4. Table 3 is important when the three risk factors were evaluated preoperatively. However, the
limitation in this table is a small number of cases. Please add 95% CIs for the proportions of
LNM in each subcategory.
5. Outcome measurement subsection should be included and the detail including the reasons
why candidate variables were selected should be explained in the Methods section. The authors
evaluated many analyses, such as 1) preoperative risk factors for LNM, 2) postoperative risk
factors for LNM, 3) the combination of preoperative (?) factors for predicting LNM, and 4) risk
factors for exceeding the expanded indication. However, it is sometimes difficult to understand
why some candidate variables were selected in the analyses, especially in 4).
6. Please add the status of lymphovascular invasion in Table 4.
7. SM1 (tumor invasion into submucosa <500 µm) and SM2 (tumor invasion into submucosa
#500 µm) are important for LNM, according to the Japanese guidelines. Please divide SM into
SM1 and SM2 in the postoperative analysis of Table 2.
8. The authors concluded that depressed type is at high risk for exceeding the expanded
indication, but flat type also had a significant risk for exceeding the expanded indication. Please
improve the results and conclusion including the abstract.
9. Although the authors suggested that preoperative evaluation should be cautious when the
lesion is depressed (maybe flat type should be included), most UEGCs are flat or depressed type.
In this study, about 94% (325/346) of UEGCs were flat or depressed type. In a prior multicenter
prospective study (Gastric Cancer. 2021; 24: 479-91.), 99% of UEGCs were flat or depressed
type.
Minor
1. Lines 138: Please change “<2 cm” into “#2 cm.”
2. Lines 169: Please change “<1 cm” into “#1 cm.”
Review for 10.1186/s12876-023-02771-x (2023)

Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 1 Date: 07 Jan 2023
Reviewer:  Takeshi Kubota
Reviewer's report:
The authors assessed the feasibility of endoscopic submucosal dissection (ESD) for
undifferentiated-type early gastric cancer (UEGC) by analyzing the risk factors for lymph
node metastasis (LNM) after curative gastrectomy. The results are convincing and valuable
for clinical practice. However, the similar larger scale analysis has been performed (1), which
has already been indicated in Japanese guidelines and cited worldwide. In addition, some
confirmatory trials have already been done and published (2,3). Furthermore, it did not notice
a big difference in the results. The authors described in the ‘Background’ that ESD for UEGC
is still not widespread in China because of the lack of confidence in curative resection by both
endoscopists and patients, but, basiclally, the subject is the same Asian population as the above
cited references.
(1) Hirasawa T, Gotoda T, Miyata S, et al. Incidence of lymph node metastasis and the
feasibility of endoscopic resection for undifferentiated-type early gastric cancer. Gastric Cancer.
2009;12(3):148-52.
(2) Hasuike N, Ono H, Boku N, et al. Gastrointestinal Endoscopy Group of Japan Clinical
Oncology Group (JCOG-GIESG). A non-randomized confirmatory trial of an expanded
indication for endoscopic submucosal dissection for intestinal-type gastric cancer (cT1a): the
Japan Clinical Oncology Group study (JCOG0607). Gastric Cancer. 2018 Jan;21(1):114-123.
(3) Takizawa K, Ono H, Hasuike N, et al. Gastrointestinal Endoscopy Group (GIESG) and the
Stomach Cancer Study Group (SCSG) of Japan Clinical Oncology Group. A nonrandomized,
single-arm confirmatory trial of expanded endoscopic submucosal dissection indication for
undifferentiated early gastric cancer: Japan Clinical Oncology Group study (JCOG1009/1010).
Gastric Cancer. 2021 Mar;24(2):479-491.
Other major comments
1. In preoperative endoscopic diagnosis, which decides the indication of ESD, it must be said
that it is fatal not to perform EUS.
2. Multivariate analysis with factors of 8-9 for 69 events (LNM) is unreasonable.
3. The description regarding risk factors for LNM in UEGC in the ‘Result’ section that their size
was larger, and the proportions of ulceration, SM infiltration, and LVI were also significantly
higher (P<0.05) is understandable. However, although the authors touch the result that there is
a difference in the presence or absence of LNM due to differences in BMI, Hb, and PLR in
the 3rd paragraph of the ‘Discussion’ section, the content is unclear. Are NLR, PLR, and MLR
necessary for this analysis?
Minor comments
1. The number of female patients in the text of results is different from the number in Table1.
2. The border of tumor size is <2cm in the text of ‘Result’, whereas it is #2cm in Table 1.
3. In Table 1and 4: ‘Fmale’, ‘fmale’ # ‘Female’, ‘female’.
4. In Table 3, please clarify which includes just 2cm.
Review for 10.1186/s12876-023-02771-x (2023)

Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 2 Date: 01 Mar 2023
Reviewer's report:
Thank you for revising the manuscript. Unfortunately, some of responses are not satisfactory.
1. I understand the limitations in the retrospective design, but, if the authors use “preoperatively
assessable factors,” it is not appropriate to evaluate SM or ulceration by using histological data.
Especially, it is strange to evaluate preoperative and postoperative SM as the same factor in
Table 2, and the same can be said about ulceration. At least, clear description about this limitation
is mandatory.
2. Some data of 95% CI in Table 3 are wrong. For example, the lower limit of 95% CI of 20.0%
is described as 0.36 (maybe it means 36%). It is strange.
3. Outcome measure subsection was not added in the revised manuscript and the reasons for
selecting candidate variables were not also added, despite the reviewer’s recommendation. The
reasons shown by the authors are not reasonable for the scientific journal. Please add them.
4. Distinction of SM1 and SM2 is important. SM2 can be differentiated from SM1 even in the
surgical specimen, according to the Japanese guidelines. At least, clear description about this
limitation is required.
5. The authors suggested that preoperative evaluation should be cautious when the lesion is
depressed, flat or located in the cardia, 94-99% of undifferentiated early gastric cancer are flat
or depressed type, as shown in my previous report. Thus, it means that preoperative evaluation
should be cautious in most of undifferentiated early gastric cancer. This message may be strange,
and it was not improved in the revised version.
Review for 10.1186/s12876-023-02771-x (2023)

Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 2 Date: 04 Mar 2023
Reviewer's report:
Ref: Submission ID 524eff8e-6a96-4340-995a-b865a21e8094
"Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection in
Undifferentiated-type Early Gastric Cancer".
In the authors' response letter, the authors stated that, "We performed ESD in 13 patients
with UEGC (between January 2014 and December 2021), two patients were lost to follow-
up. Additional surgery were performed in 7 cases, one of them had positive LNM(1/7). The
other 4 cases were followed up until now, only 1 case had distant lymph node metastasis. There
were no LNM(+) in patients with expanded indications for ESD." It is strongly recommended
that this information, particularly the number of patients who received ESD, be included in the
manuscript.
Review for 10.1186/s12876-023-02771-x (2023)

Title: Risk of Lymph Node Metastasis and Feasibility of Endoscopic Submucosal Dissection
in Undifferentiated-type Early Gastric Cancer
Version: 7 Date: 12 Apr 2023
Reviewer's report:
The manuscript has been revised in accordance with the critiques proffered by the reviewer.
Review for 10.1186/s12876-023-02802-7 (2023)

Title: A Nomogram for predicting cause-specific mortality among patients with cecal
carcinoma: A study based on SEER database
Version: 0 Date: 13 Feb 2023
Reviewer:  Ling Tong
Reviewer's report:
This study estimated the probabilities of cause-specific mortality in patients with cecal
carcinoma (CC) and to build a competing risk nomogram to quantify the effects of multiple
variables. Independent predictor variables were pathologic classification of cancer, tumor grade,
AJCC stage, T stage, etc. The nomogram can help clinicians choose appropriate options for
rehabilitation and follow-up strategies conducive to the survival of CC patients. The study is
well conducted and the level of details is sufficient. The manuscript is well written and easy
to understand.
My questions are mostly focused on the explanation of model and results:
1. In discussion, can you explain the reason why the Kaplan-Meier curve and Cox proportional
hazard models tend to produce inaccurate estimates? If you could compare the prediction
with the Kaplan-Meier curve or Cox proportional hazard models, that would provide more
information about how the model would overestimate or underestimate the mortality.
2. I believe the tumor grade, tumor size, and AJCC stage are highly correlated. How do you
address the collinearity? Do you think the high correlation of these variables may bias the CC
mortality prediction?
3. In conclusion, you mentioned that the nomogram constructed in the present study can help
clinicians choose appropriate options for rehabilitation and follow-up strategies conducive to
the survival of CC patients. What demographic or clinical factors do you suggest focusing on
in the process of making a diagnosis?
4. How would you interpret the AUC of 0.841, 0.862 and 0.852 for 1-, 3-, and 5-year survival
prediction? Are they sufficiently accurate to be applied in clinical practice to provide reliable
clinical decision support for clinicians?
Review for 10.1186/s12876-023-02802-7 (2023)

Title: A Nomogram for predicting cause-specific mortality among patients with cecal
carcinoma: A study based on SEER database
Version: 0 Date: 29 Mar 2023
Reviewer's report:
The authors identified some independent predictor variables for predicting cause-specific
mortality among patients with cecal carcinoma by analyzing SEER database. The manuscript
benefits cecal carcinoma clinical study. However, there are some points that need to be
addressed.
Comment 1: The first major defect of this study is the debate or argument is not clear stated in
the introduction session. Hence, the contribution is weak in this manuscript. I would suggest the
authors to enhance their theoretical discussion and arrives their debate or argument.
Comment 2: It is preferable to write the  summary (abstract) of the study in a clearer and more
comprehensive manner in order to reflect the study.
Comment 3: It is suggested to present the structure of the article at the end of the introduction.
Comment 4: In the statistical analysis part, only what is related to the statistical analysis that
was conducted in the study should be written.
Comment 5: The second major defect of this study is the interpretations of  results was not
enough, so  much more explanations and interpretations must be added for the results.
Comment 6: More suitable title should be presented for each figures.
Comment 7: It is suggested to compare the results of the present study with some similar studies
which is done before.
Comment 8: Please revise your conclusion part into more details. Basically, you should enhance
your contributions, limitations, underscore the scientific value added of your paper, and/or the
applicability of your findings/results and future study in this session.
Comment 9: It is best to review the manuscript in relation to the language.
Comment 10: Some of the paragraphs in the manuscript should be repositioned to its
correct position., so please rearrange it. For example page 5 “The demographic and clinical
characteristics of patients were obtained for the analysis of the training and validation dataset.”
And   “As for tumor characteristics, TNM staging conformed to the seventh edition of the AJCC
Cancer Staging Manual, stage grouping was in line with AJCC Stage third edition, and tumor
grading was determined according to the International Classification of Diseases Oncology
second edition (ICD-O-2).”
Review for 10.1186/s12876-023-02802-7 (2023)

Title: A Nomogram for predicting cause-specific mortality among patients with cecal
carcinoma: A study based on SEER database
Version: 1 Date: 03 May 2023
Reviewer:  Ling Tong
Reviewer's report:
The author have answered my questions perfectly and made changes to the manuscript
accordingly. The manuscript quality have improved significantly. I have no other questions for
the manuscript for the argument and contributions they claimed.  I recommend the publication.
Review for 10.1186/s12876-023-02822-3 (2023)

Title: Confocal endomicroscopy diagnostic criteria for early signet-ring cell carcinoma in
hereditary diffuse gastric cancer
Version: 1 Date: 13 Dec 2021
Reviewer:  Cristina Trovato
Reviewer's report:
The manuscript is readable and the Authors well elucidated limitations.
The Authors hypothesized that probe-based confocal laser endomicroscopy (pCLE) might help
diagnose early cancerous lesions in the context of HDGC.
In a previous report (Schueler SA et al, 2021) pCLE alone has low sensitivity for occult cancer
detection in CDH1 variant carriers, but in this paper a systematic approach to identification of
diagnostic criteria has not been used.
In this study the Authors used a strict multi-stage process to identify and validate off-line pCLE
criteria for a diagnosis of signet ring cell carcinoma (SRCC). The criteria identified have 81%
sensitivity and 71% specificity. These do not relate to the signet ring cells per se, but rather
reflect indirect effects on the tissue architecture of the SRCC foci. Real-time validation of these
criteria is required.
Specific Comments:
1) References style requires revision.
2) Reference n. 22 is incomplete, better to cite it as follows: Schueler SA, Gamble LA, Curtin
BF, Ruff SM, Connolly M, Hannah C, et al. Evaluation of confocal laser endomicroscopy for
detection of occult gastric carcinoma in CDH1 variant carriers. J Gastrointest Oncol. 2021
Apr;12(2):216-225.
Review for 10.1186/s12876-023-02822-3 (2023)

Title: Confocal endomicroscopy diagnostic criteria for early signet-ring cell carcinoma in
hereditary diffuse gastric cancer
Version: 1 Date: 31 Dec 2021
Reviewer:  Helga Bertani
Reviewer's report:
The primary aim of the study ‘Confocal endomicroscopy diagnostic criteria for early signet-ring
cell carcinoma in hereditary diffuse gastric cancer’  was to identify and validate pCLE diagnostic
criteria for early SRCC in HDGC syndrome and is clearly specified.
The paper is an original contribution about the use of confocal endomicroscopy in a selected
population at high risk of SRCC. Previous published paper about the use of high definition
endoscopy and/or pCLE in the stomach failed in the demonstration of a significant added value
of these techniques in the early detection, consequently an intensive random biopsies protocol
is recommended.
The paper is very well written and clear, and the study is well conducted with a strong
methodology.
The strength of the study is a serious and strict multi-stage process to identify and validate the
pCLE criteria. Moreover the investigators have and extensive expertise in the field of confocal
endomicroscopy and endoscopic detection of upper neoplastic disease.
Major comments:
1: pCLE criteria were not related to identification of “signet ring cell criteria” but to “indirect”
effect on nearby tissue modifications. This is indeed a weak spot of the study. The author
should evaluate if the same criteria are found in other conditions such as HP infection, intestinal
metaplasia, atrophic gastritis as none of this condition has been investigated in the study and are
commonly found. Is it possible to validate the established criteria in a dataset that includes HP
infection, intestinal metaplasia, atrophic gastritis?
2: Pale areas identified on WLI and NBI are used as a lighthouse to perform pCLE and in a
identification and in a “validation setting” this could be considered a bias.
3: SRCC usually develops under epithelial surface consequently pCLE weak spot is the depth
of penetration.
Review for 10.1186/s12876-023-02822-3 (2023)

Title: Confocal endomicroscopy diagnostic criteria for early signet-ring cell carcinoma in
hereditary diffuse gastric cancer
Version: 4 Date: 01 Mar 2022
Reviewer:  Cristina Trovato
Reviewer's report:
The revised version of the manuscript includes more detailed discussion on the limitations of
the study as required by reviewer 2.
The authors' answer is reasonable and sufficient.
Review for 10.1186/s12876-023-02822-3 (2023)

Title: Confocal endomicroscopy diagnostic criteria for early signet-ring cell carcinoma in
hereditary diffuse gastric cancer
Version: 4 Date: 03 Apr 2022
Reviewer:  Helga Bertani
Reviewer's report:
The paper is very well written, as mentioned in my previous report and the authors addressed
clearly all the comments of the reviews.
The methodology is serious and strict and I highly suggest to consider it for publication .
Review for 10.1186/s12876-023-02818-z (2023)

Title: Prognosis Prediction in Esophageal Signet-Ring-Cell Carcinoma: A competing risk
analysis
Version: 2 Date: 06 Apr 2023
Reviewer's report:
Thank you for the opportunity to review this manuscript. The authors made a risk nomogram
for the cancer-specific survival of esophageal signet ring cell carcinoma.
This manuscript is well-written and valuable. However, there are some points to be addressed
before publication.
1. What do the authors think is the clinical implication of this study? How do the authors think
this results apply the clinical practice?
2. The reason why  CSS was poorer in the male than in the female was insufficient. Please add
the reason in the discussion.
3. SHR of T3-4 were significantly lower than T1 in Validation cohort in Table 2. What made
this result?
Review for 10.1186/s12876-023-02818-z (2023)

Title: Prognosis Prediction in Esophageal Signet-Ring-Cell Carcinoma: A competing risk
analysis
Version: 2 Date: 15 Apr 2023
Reviewer's report:
This manuscript presents interesting risk nomogram model for esophageal signet-ring-cell
carcinoma which is very rare histologic type in esophageal cancer.
I have some question for this manuscript as indicated below.
1) Once the author has defined the abbreviation of “Esophageal Signet-ring cell carcinoma” as
ESRCC in Page 2, the terms that appears in subsequent sentences (Page 2 and 3) should use
that abbreviation.
2) I think that signet ring cell carcinoma is a special subtype of poorly differentiated
adenocarcinoma, and which is defined as differentiated grade III (or IV). Although the subject
include grade of differentiation I-II, does this mean that patients with even a small amount of
signet-ring-cell carcinoma component are included in this study? Is that appropriate as a study
to examine the characteristics of signet-ring-cell carcinoma.
3) I think that the number of all include patients described in Line 2, Page 6, Line 24, Page 8
is incorrect.
4) In the first paragraph of 2.2 (Page 3-4), the covariates are described as “A and B” in the first
half, but described as “A or B” in the latter half, why not unify them?
5) About “which was exactly consistent with previous findings…” in Line 10, Page 10.
I think that this sentence gives a false impression because the cited articles reported a tendency
for higher incidence in men, but not a poor prognosis in men.
6) Do the results of this study suggest that being highly advanced Stage which is no indication of
surgery is a prognostic factor? Or, if there are ESRCC patients with same level of progression,
would patients receiving surgery have a worse prognosis?
7) Because surgery is one of the factors of this nomogram in the study, we can only use this
nomogram after we have opted for treatment. How the use of the nomogram for clinical decision
making?
I hope those comments will be helpful for the improvement of the article.
Review for 10.1186/s12876-023-02774-8 (2023)

Title: Developing Patient-Refined Colorectal Cancer Screening Materials: Application of a
Virtual Community Engagement Approach
Version: 1 Date: 15 Feb 2023
Reviewer:  Margaret Kemeny
Reviewer's report:
1. It would be good to be able to see the virtual version of the boot camp translation in the
appendix
2. Do we have any idea if this  virtual experience resulted in more compliance with screening
Review for 10.1186/s12876-023-02774-8 (2023)

Title: Developing Patient-Refined Colorectal Cancer Screening Materials: Application of a
Virtual Community Engagement Approach
Version: 1 Date: 05 Mar 2023
Reviewer's report:
Thank you for your contribution to the continued conversation about how to engage targeted
communities for developing culturally tailored materials.  I think this article is a valuable
contribution to the literature.
In the discussion section, while limitations were noted, I would have liked to see a bit more
about lessons learned and possible adaptations based on this experience for future and ongoing
research.
It was noted that the success of the BCT was limited by the reach/participation would you
consider another approach beyond or different from BCT in the future based on these data?
Please describe further.
Review for 10.1186/s12876-023-02821-4 (2023)

Title: High Correlation of Hepatic Shear Wave Velocity with Esophageal Varices Complication
Rate in Patients with Chronic Liver Diseases
Version: 1 Date: 31 Mar 2023
Reviewer's report:
This article mainly studied the correlation between hepatic pSWE and the degree of liver fibrosis/
EV , as well as its non-invasive diagnostic value in  CLD patiengts. At the same time, this study
also compared the diagnostic accuracy of pSWE with serological and histological indicators.
Overall, this study has clear ideas, appropriate analytical methods, and reliable conclusions.
However, the main problem is the lack of innovation, as a large number of studies worldwide
have verified the strong correlation between liver  elasticity and chronic liver disease fibrosis
and its complications.
Personally, if you want to improve the innovative value of this article, why the diagnostic value
of liver elasticity is superior to spleen volume should be explored, especially in the diagnosis
of EV, because there have been many studies suggesting that the diagnostic value of spleen
elasticity for HRV/CSPH is superior to liver elasticity.
Review for 10.1186/s12876-023-02821-4 (2023)

Title: High Correlation of Hepatic Shear Wave Velocity with Esophageal Varices Complication
Rate in Patients with Chronic Liver Diseases
Version: 1 Date: 06 Apr 2023
Reviewer's report:
The authors investigated the correlations of pSWE with hepatic inflammation/fibrosis,
functional hepatic reserve, and related diseases in patients with CLD. They showed that pSWE
was highly correlated with hepatic fibrosis and EV complication. The findings are already
reported in the previous studies. I have several considerable concerns.
Major comments
#1. The numbers of patients studied are too small. The number of total patients studied is only
71. EVs are assessed only in 45 patients.
#2. The pathogenesis of CLD is heterogeneous, which is likely to affect the relationship of pSWE
values to fibrosis or EVs.
#3. Some patients have severe exacerbation with high ALT levels which are likely to affect the
pSWE values.
#4. They should perform the statistical comparison of the AUCROC of pSWE values with those
of the other factors for detecting cirrhosis and EVs.
#5. They should suggest the cut-off values of pSWE values for cirrhosis and EVs.
#6. The authors used parametric methods (mean ± SD and Pearson product-moment correlation
efficient) and nonparametric methods (median, interquartile range and Mann-Whitney U test).
I think that it is inappropriate to use different methods to analyze the same data.
Minor comments
#1. P5, line 7. Some words must be omitted by error.
#2. P9, line 10. There is redundancy of “and”.
#3. P10, lines14-16. Ref. 24 is not Park’s.
Review for 10.1186/s12876-023-02821-4 (2023)

Title: High Correlation of Hepatic Shear Wave Velocity with Esophageal Varices Complication
Rate in Patients with Chronic Liver Diseases
Version: 3 Date: 01 May 2023
Reviewer's report:
The authors revised the manuscript according to my comments. But I still have a major concern.
#1. Abstract. “The area under the curve (AUC) of Vs was 0.902; it was a better indicator for
cirrhosis (F4) than blood markers. The AUC for predicting EVs by Vs was 0.901, which was
higher than those of histological fibrosis stage, blood markers, and splenic volume.”
These sentences are wrong, since they described the results of statistical analysis in Results as
below.
Comparison of ROC curves showed that AUROC for predicting cirrhosis of Vs value was not
significantly different from AUROC for FIB-4 index, platelet count, hyaluronic acid and type
IV collagen 7S, while it was significantly different from AUROC for M2BPGi (P<0.01).
Comparison of ROC curves showed that AUROC for predicting EVs of Vs value was not
significantly different from AUROC for fibrosis stage 3-4 (liver biopsy) and type IV collagen
7S, while it was significantly different from AUROC for FIB-4 index (P<0.05), platelet count
(P<0.05), M2BPGi (P<0.01), hyaluronic acid (P<0.05) and splenic volume (P<0.05).
Review for 10.1186/s12876-023-02790-8 (2023)

Title: Acute idiopathic pancreatitis is associated with more aggressive disease course in Crohn’s
disease but not in ulcerative colitis
Version: 3 Date: 23 Mar 2023
Reviewer's report:
complements to the authors for a well written manuscript. I have few comments to make
1. Introduction: authors would consider changing EIM "approximately involves 24% of IBD"
to "involves Upto 24% of IBD"
2. Methodology: a figure on study flow would be helpful.
All inclusion criteria can be mentioned at one place..like only first case of AIP will be included
has been mentioned separately.
3. what would be the impact of Recurrent AIP if they were to be included for analysis
4. How do authors justify presence of such high numbers of EIM in CD patients.
5.DIscussion: authors can under play  findings like "A further observation of this study
demonstrated a statistically significant 10-fold increase in the risk of recurrence of acute
idiopathic pancreatitis in comparison to other causes of pancreatitis in UC patients". such
remarks in small sample study can be appear stretched.
Review for 10.1186/s12876-023-02790-8 (2023)

Title: Acute idiopathic pancreatitis is associated with more aggressive disease course in Crohn’s
disease but not in ulcerative colitis
Version: 3 Date: 26 Mar 2023
Reviewer:  Saurabh Dawra
Reviewer's report:
A very  well brought out thought provoking study. However, a few queries remain
1. It would be interesting to analyze as to how many patients of Acute pancreatitis were admitted
at your centre over a course of 09 years(2011-2020). You have mentioned   7231  patients of
IBD out of which you could find only 53 who match your research criteria(IBD+ AP).  Is it
disease association or ‘collider bias’ that a few people may have both diseases.
2. In the CD cohort, two patients had a complicated course of AP, including one episode of
acute idiopathic pancreatitis complicated by pseudocyst and necrotizing pancreatitis, and one
episode of endoscopic retrograde cholangiopancreatography (ERCP)-induced pancreatitis with
pseudocyst formation. Was this patient with Post  ERCP AP included? If yes how is it idiopathic?
3. It is interesting to note that 26.42% (14/53) had ‘recurrent AP’. Do you have follow up data
on this subset of ‘recurrent AP’?  What is the diagnostic criteria of recurrent AP followed in
your study? This is prudent as these patients of  ‘recurrent AP’ might actually be those who have
developed chronic pancreatitis and these pain episodes were attributable to Acute pancreatitis
in the first place
4. Again you have mentioned that ‘one patient with CD who had an episode of gallstone
pancreatitis followed by an episode of ERCP-induced pancreatitis 6 years later’. Was this patient
included in analysis? How is it idiopathic if he/ she has had both gall stone related and post
ERCP pancreatitis?
5. The discussion part may be modified to justify the statement as to how the occurrence of AP in
0.73 % of patients with IBD qualifies to be termed as ‘ extra intestinal manifestation’? while the
occurrence of the same disease(API) in general population is ‘10 -35 %’. In the same discussion
the authors urge the readers to interpret the results with ‘caution’
Review for 10.1186/s12876-023-02790-8 (2023)

Title: Acute idiopathic pancreatitis is associated with more aggressive disease course in Crohn’s
disease but not in ulcerative colitis
Version: 4 Date: 20 Apr 2023
Reviewer:  Saurabh Dawra
Reviewer's report:
The queries have been answered satisfactorily
Review for 10.1186/s12876-023-02790-8 (2023)

Title: Acute idiopathic pancreatitis is associated with more aggressive disease course in Crohn’s
disease but not in ulcerative colitis
Version: 4 Date: 27 Apr 2023
Reviewer's report:
authors have addressed all the points and have appropriately downplayed the findings due to
study limitation.
Review for 10.1186/s12876-023-02785-5 (2023)

Title: Fatty liver index relationship with bio markers and lifestyle: Result from RaNCD cohort
study
Version: 2 Date: 08 Feb 2023
Reviewer's report:
I believe that the authors have sufficiently addressed the previously mentioned concerns and
questions. However, there are still a few issues that I would like to discuss.
1. English needs to be revised. Particularly, in the abstract and discussion of the manuscript..
2. Abstract: In my opinion, the way the results are expressed in the abstract makes them difficult
to understand. For example "The probability of NAFLD in men with high physical activity was
significantly 56% and in women 46% lower than in men and women with low physical activity
(P<0.001)". Could the sentence be rephrased?
For example: " An adjusted logistic regression model showed a significantly negative association
between high physical activity and fatty liver index in both men and women. (OR: 0.44, p-
value<0.001 and OR: 0.54, p-value<0.001, respectively)".
3. Abstract: "The present study showed that high SES, increased energy intake, dyslipidaemia,
physical inactivity, high VFA and depression in female are associated with an increased risk
of NAFLD." The conclusions expressed in this way seem to mean that these results were only
observed in female. Could the authors please rephrase the conclusions trying to state them as
clearly as possible?
4. Discussion: “Our findings showed a statistically significant link between the incidence of
NAFLD and blood biomarkers such as TG, TC, LDL-C, HDL-C, and FBG”. I would suggest
changing link to differences." Our findings showed statistically significant differences between
the incidence of NAFLD and blood biomarkers such as TG, TC, LDL-C, HDL-C and FBG,
when comparing subjects with an FLI<60 vs. FLI #60.".
5. Discussion: “Insulin resistance is sometimes referred to as prediabetes with baseline FBG
readings between 110 and 126 mg/dl. indicated that this individual would be very likely
to acquire NAFLD (25).” This sentence does not flow. I suggest either to add some more
information related to the results obtained in the manuscript or to rephrase it in a different way.
6. Discussion “A decreased risk of NAFLD was linked to higher HEI-2015 scores”. The authors’
state this. However, in the logistic regression model provided, the association between HEI-2015
scores and NAFLD risk is not assessed.
7. Please reformulate and clarify general conclusions.