Review for 10.1186/s12876-022-02338-2 (2022)

Reviewer’s report
Title: 
Clinicopathological characteristics of pancreatic acinar cell metaplasia
associated with  Helicobacter pylori  infection
Version: 
1 
Date: 
30 Mar 2022
Reviewer's report:
1. The manuscript focuses on PACM in the gastric mucosa, a rare phenomenon.
The authors report results from a large sample study. The showed that the
frequencies of PACM were 0.49% (10/2039), 0.75% (25/3332), and 0% (0/559)
in the CHI, PHE, and NHI groups, respectively. However, in my opinion, the
study just repeatedly confirms the rare of PACM in the gastric mucosa. I'm not
sure the significance of the findings, especially in consideration of the very low
frequency of PACM in the gastric mucosa. The authors should clearly declare
the value of the study.
2. H. pylori infection is closely associated to gastric cancer. The study indicates
that PACM is closely related to H. pylori. Therefore, it's better to analyze or at
least discuss the relationship between PACM and gastric cancer.
3. How to explain the higher rate of PACM in PHE than that in CHI.
4. PACM is evaluated by samples from gastric biopsy. However, the site
underwent biopsy always means abnormity during the observation of
gastrointestinal endoscopy. The results of this study may just represent the
relationship in pathological conditions, which showed be discussed as a
limitation.
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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?
No
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes