Review for 10.1186/s12876-022-02151-x (2022)

Reviewer’s report
Title: 
Characteristics and potential malignancy of colorectal juvenile polyps in
adults: A single-center retrospective study in China
Version: 
0 
Date: 
02 Dec 2021
Reviewer's report:
Manuscript Number: BMGE-D-21-00243
CHARACTERISTICS AND POTENTIAL MALIGNANCY OF
COLORECTAL JUVENILE POLYPS IN ADULTS: A SINGLE-CENTER
RETROSPECTIVE STUDY IN CHINA
The authors share their experience with patients with colorectal juvenile polyps
focusing, I guess, on their potential of malignancy. The topic sounds interesting,
and the manuscript easily readable. However, I have some concerns that may
negatively influence the value of the study and the possibility of being published
in its current form. 
METHODS
- I have not so much clear in my head which are the actual objectives of the
study. Did the authors want to show the incidence of malignant polyps in a
cohort of colorectal polyps? If yes, what I understood is that one polyp only was
strictly malignant? I invite the authors to clarify the aims of the study both in the
abstract and in the introduction/methods section.
- Patients older than 18 years were included. Was the diagnosis of juvenile polyp
done before or after that age? This has to be specified since , as authors
themselves stated, juvenile polyps are much more frequent in younger patients.
- I recommend the authors to investigate the existence of an association between
characteristics of polyps (i.e. location, size, histology, Paris) and variables like ,
for instance, patient's age, gender, complaints.
RESULTS
- I do not agree with the decision of the author of creating 2 groups with so much
unbalanced number of patients ? 101 vs 2 is too much unbalanced. Moreover,
they do not actually take into consideration this classification throughout the text.
This is a little bit confusing.
- "Five patients had a history of cancer. "Which type of cancer, any? What is the
clinical relevance of it?
- I do think that mucous in the stools is quite normal. Why do you consider it a
complaint?
- What do you mean by saying that 35 juvenile polyps were found by
colonoscopy upon examination?
- Please mention Paris classification among methods and add reference.
- Why was that one patient considered to have CCR before the operation?
- "One patient… one patient… the third patient…" are they the 3 patients who
underwent surgery? Please clarify.
- Please clarify the type of surgery and the reason why the surgical option was
chosen.
- Please detail the type of endoscopic procedure performed, the instruments used,
if prophylactic epinephrine injection (and at which concentration) and/or
hemostatic clip were performed for polypectomy, anesthesia, bowel preparation,
who was the main operator, etc 
- "Neoplasia or cancerization (see the abstract) was not associated with the
number of polyps", how can you state it if 2 patients only had multiple polyps?
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Is the study design appropriate to answer the research question (including the use
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