Title: Urine Metabolomics for Assessing Fertility-sparing Treatment Efficacy in Endometrial
Cancer: A Non-invasive Approach using Ultra-performance Liquid Chromatography Mass
Spectrometry
Version: 1 Date: 28 Aug 2023
Reviewer:  Tarek Tawfik Amin
Reviewer's report:
BMC women’s Health
Title: Non-invasive Effect Evaluation for Fertility-sapring Treatment of Endometrial Cancer
based on Ultra-Performance Liquid Chromatography Mass Spectrometry Urine Metabolomics
Comments to the authors: there are many typographical and grammatical errors in the text, please
correct.
- Correct the title: sparing instead of sapring???
- The title needs some adjustment “evaluation of non-invasive fertility-sparing treatment on
endometrial cancer based on -------
Introduction:
- “As a result, a minimally invasive or noninvasive method with high specificity and sensitivity
is required to evaluate the remission rate of fertility-sparing treatment, reduce the number of
hysteroscopic operations, and improve the probability of pregnancy. In addition, conservative
treatment of EC can cause severe endometrial atrophy, complicating sampling and pathological
diagnosis. Therefore, it is crucial to identify biomarkers that can aid in evaluating treatment
effectiveness and determining whether to continue the treatment” there should be some
references to support this notion.
- “However, no studies about the effect evaluation of fertility-sparing treatment in EC patients
have been published” this sentence needed to be rewritten “no previous studies tackled the
evaluation of fertility sparing treatment in EC patients using metabolites (metabolomics)
- Rationale and hypothesis are not there???
- The last paragraph of the introduction belongs to the methods section???
- What is urine UPLC-MS?
Materials and methods:
- What is laboratory index?
- What was the study design?
- How the sample size was calculated? And how the patients were selected? The possible
confounders and the type of matching
- What was the treatments used for EC (did all peitns recived the same treatment (endocrine
treatments with oral progestins, medroxyprogesterone acetate (MPA) or megestrol acetate (MA),
or gonadotropin-releasing hormone (GnRH) or levonorgestrel-releasing intrauterine devices
(LNG-IUDs).
- It is not clear if there were surgical treatment for EC patients
- “Midstream urine samples were obtained by catheterization into a sterile container before
surgery” what surgery? Please explain. OR hyteroscopic evaluation??? Please specify
- Raw data files were processed by the Progenesis QI software based on previously strategy?????
this sentence is not complete??
- How many data was missing? “The K-nearest Neighbor algorithm was used to fill in missing
values within groups, and the minimum value method was used to fill missing value between
groups”
-
Results:
- In table 1: why using median and range instead of mean±SD, median and interquartile range???
Discussion:
- We hypothesized that increased folic acid intake might help reverse the disease, elaborate was
it your hypothesis?
- The discussion section should provide more literature and insights about the possible clinical
implications of the results of this study.
- The possible limitations of this study should be mentioned.