Title: Comparison of clinical and pathological features between early-stage gastric-type and
intestinal-type differentiated adenocarcinoma: a retrospective study
Version: 1 Date: 17 Jan 2023
Reviewer:  Hon Chi Yip
Reviewer's report:
This is an interesting study investigating the clinicopathological and magnifying endoscopic
features between differentiated gastric type and intestinal type early gastric cancer. The topic is
relevant to the readers of the journal and provided a large volume data on mucin phenotypes of
early gastric cancers. I have the following additional comments:
1. Since magnifying NBI features were one of the main outcomes of the study, please outline
the experience of the endoscopists on interpreting NBI findings, and whether there was photo
documentation and second verification of the findings. Inter-observe variability could be a
limiting factor for ME-NBI findings.
2. One of the limitation of the study is that only endoscopically resected early gastric cancer were
included. It is therefore difficult to conclude that gastric type adenocarcinoma behaved more
aggressively, as the proportion of advanced cancers were not included. Moreover, there could
be a higher difficulty to determine "clinical indication" for ESD in gastric type adenocarcinoma,
thus leading to a higher incidence of non-curative resection. There seems to be a trend of more
depressed lesions than elevated lesions for gastric type cancer, which could translate to a more
difficult determination of ESD suitability. This should be addressed in the discussion part.
3. Although there was a significant difference in the microvascular pattern between GDA and
IGA, the proportion of ILL and FNP in  each group made it difficult to use it as  a meaningful
diagnostic tool. The authors may need to describe the usefulness of differentiating ILL from
FNP or if any additional diagnostic criteria may be helpful.
3. Minor comments
- Japanese ESD guidelines should be properly referenced.
- Reference 17 was incorrect
Title: Comparison of clinical and pathological features between early-stage gastric-type and
intestinal-type differentiated adenocarcinoma: a retrospective study
Version: 1 Date: 17 Jan 2023
Reviewer:  Hon Chi Yip
Reviewer's report:
This is an interesting study investigating the clinicopathological and magnifying endoscopic
features between differentiated gastric type and intestinal type early gastric cancer. The topic is
relevant to the readers of the journal and provided a large volume data on mucin phenotypes of
early gastric cancers. I have the following additional comments:
1. Since magnifying NBI features were one of the main outcomes of the study, please outline
the experience of the endoscopists on interpreting NBI findings, and whether there was photo
documentation and second verification of the findings. Inter-observe variability could be a
limiting factor for ME-NBI findings.
2. One of the limitation of the study is that only endoscopically resected early gastric cancer were
included. It is therefore difficult to conclude that gastric type adenocarcinoma behaved more
aggressively, as the proportion of advanced cancers were not included. Moreover, there could
be a higher difficulty to determine "clinical indication" for ESD in gastric type adenocarcinoma,
thus leading to a higher incidence of non-curative resection. There seems to be a trend of more
depressed lesions than elevated lesions for gastric type cancer, which could translate to a more
difficult determination of ESD suitability. This should be addressed in the discussion part.
3. Although there was a significant difference in the microvascular pattern between GDA and
IGA, the proportion of ILL and FNP in  each group made it difficult to use it as  a meaningful
diagnostic tool. The authors may need to describe the usefulness of differentiating ILL from
FNP or if any additional diagnostic criteria may be helpful.
3. Minor comments
- Japanese ESD guidelines should be properly referenced.
- Reference 17 was incorrect
Please review this paper.
user
Title: Comparison of clinical and pathological features between early-stage gastric-type and
intestinal-type differentiated adenocarcinoma: a retrospective study
Version: 1 Date: 17 Jan 2023
Reviewer:  Hon Chi Yip
Reviewer's report:
This is an interesting study investigating the clinicopathological and magnifying endoscopic
features between differentiated gastric type and intestinal type early gastric cancer. The topic is
relevant to the readers of the journal and provided a large volume data on mucin phenotypes of
early gastric cancers. I have the following additional comments:
1. Since magnifying NBI features were one of the main outcomes of the study, please outline
the experience of the endoscopists on interpreting NBI findings, and whether there was photo
documentation and second verification of the findings. Inter-observe variability could be a
limiting factor for ME-NBI findings.
2. One of the limitation of the study is that only endoscopically resected early gastric cancer were
included. It is therefore difficult to conclude that gastric type adenocarcinoma behaved more
aggressively, as the proportion of advanced cancers were not included. Moreover, there could
be a higher difficulty to determine "clinical indication" for ESD in gastric type adenocarcinoma,
thus leading to a higher incidence of non-curative resection. There seems to be a trend of more
depressed lesions than elevated lesions for gastric type cancer, which could translate to a more
difficult determination of ESD suitability. This should be addressed in the discussion part.
3. Although there was a significant difference in the microvascular pattern between GDA and
IGA, the proportion of ILL and FNP in  each group made it difficult to use it as  a meaningful
diagnostic tool. The authors may need to describe the usefulness of differentiating ILL from
FNP or if any additional diagnostic criteria may be helpful.
3. Minor comments
- Japanese ESD guidelines should be properly referenced.
- Reference 17 was incorrect
assistant