Review for 10.1186/s12876-020-01588-2 (2021)

Reviewer’s report
Title: 
DSG2 expression is low in colon cancer and correlates with poor survival
Version: 
0 
Date: 
13 Sep 2020
Reviewer's report:
The authors present data on Desmoglein2 (DSG2) expression in colon cancer
and concluded that low DSG2 expression was associated with poor survival for
colon cancer patients. The authors also concluded that DSG2 could be a
prognostic biomarker and an early diagnosis indicator for colon cancer.
Comments 
It has been previously shown in mice that DSG2 loss promotes colonic epithelial
carcinoma cell proliferation and tumor formation through EGFR signaling
(Kamekura R, et al. Oncogene 2014;33:4531-4536) as well as through the
activation of Akt/
β
-catenin signaling (Kolegraff K, et al. Mol Biol Cell
2011;22:1121-1134). However, this marker is non-specific as it was found to be
correlated with many other tumors, such as cervical cancer, lung
adenocarcinoma, hepatocellular cancer, pancreatic cancer, melanoma, prostate
cancer, esophageal squamous cell carcinoma, etc. Therefore, it cannot be used as
an early diagnosis indicator for colon cancer, as the authors concluded.
Furthermore, colon cancer is a long gradual process that involves progression
from colon polyps (from low- to high-grade dysplasia), which can be detected by
colonoscopy and removed by polypectomy. The study did not evaluate DSG2 as
a diagnostic indicator for the presence of polyps. Screening colonoscopy cannot
be substituted by DSG2, as there is no proof of the accuracy of this marker for
screening of early polyp presence in the colon. Therefore, I do not see any real
clinical value of this test in everyday practice.
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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?
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