Reviewer's report
Title:Alpha-Fetoprotein Level as a Biomarker of Liver Fibrosis Status in 621
consecutive patients with Chronic Hepatitis B
Version: 1Date:10 September 2013
Reviewer: Anna Pecorelli
Reviewer's report:
Major Compulsory Revisions:
1) Materials and Methods, Patients, second paragraph: there are few data about
study populations’ characteristics , for example: median value of ALT and AST,
percentage of obese patients or patients with metabolic syndrome, diabetes or
dislipedemia are included (these patients in fact could be affected by NASH
which can contribute to liver damage.)
2) Materials and Methods, Patients, second paragraph: how HCC has been
excluded? Which imaging techniques have been used? And which criteria has
been adopted?
3) Materials and Methods, Methods, Liver biopsy and histopathology, first
paragraph: it is no specified if biopsies were made by different clinicians.
Different experience could influence for example the length of the tissue
samples.
4) Materials and Methods, Methods, Liver biopsy and histopathology, first
paragraph: if possible specify the median length of tissue samples. 15 mm is too
small (a length of at least 25 mm is necessary to evaluate fibrosis accurately).
5) Results, Demographic characteristics, first paragraph: patients < 12 years old
should be excluded because the possible different behavior of AFP in child.
6) Results, Demographic characteristics, first paragraph: no data are available on
the HBV infection duration. Specify the median duration of CHB.
7) Results, Demographic characteristics, first paragraph: there are too many
patients in inflammation and fibrosis stage 3-4 (more than half).
8) Results, Correlation of AFP versus liver inflammation and fibrosis stage: insert
a figure with all values of AFP for each stage of inflammation and fibrosis, not
just a table.
9) Discussion, first paragraph: it’s mandatory to evaluate the correlation between
AFP and ALT, AST and Gamma-GT.
10) Discussion, first paragraph: it’s mandatory to evaluate the reproducibility of
AFP test dosages.
11) Discussion, first paragraph: the discussion about age and gender should be
included in the results not in the discussion.
12) Discussion, first paragraph: it is mandatory a multivariate analysis of age and
sex.
13) Discussion, fourth paragraph: it is unacceptable not include ALT values for
each patient, which is an inclusion criterion for the diagnosis of CHB as specified
in the text.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Reviewer's report
Title:Alpha-Fetoprotein Level as a Biomarker of Liver Fibrosis Status in 621
consecutive patients with Chronic Hepatitis B
Version: 1Date:10 September 2013
Reviewer: Anna Pecorelli
Reviewer's report:
Major Compulsory Revisions:
1) Materials and Methods, Patients, second paragraph: there are few data about
study populations’ characteristics , for example: median value of ALT and AST,
percentage of obese patients or patients with metabolic syndrome, diabetes or
dislipedemia are included (these patients in fact could be affected by NASH
which can contribute to liver damage.)
2) Materials and Methods, Patients, second paragraph: how HCC has been
excluded? Which imaging techniques have been used? And which criteria has
been adopted?
3) Materials and Methods, Methods, Liver biopsy and histopathology, first
paragraph: it is no specified if biopsies were made by different clinicians.
Different experience could influence for example the length of the tissue
samples.
4) Materials and Methods, Methods, Liver biopsy and histopathology, first
paragraph: if possible specify the median length of tissue samples. 15 mm is too
small (a length of at least 25 mm is necessary to evaluate fibrosis accurately).
5) Results, Demographic characteristics, first paragraph: patients < 12 years old
should be excluded because the possible different behavior of AFP in child.
6) Results, Demographic characteristics, first paragraph: no data are available on
the HBV infection duration. Specify the median duration of CHB.
7) Results, Demographic characteristics, first paragraph: there are too many
patients in inflammation and fibrosis stage 3-4 (more than half).
8) Results, Correlation of AFP versus liver inflammation and fibrosis stage: insert
a figure with all values of AFP for each stage of inflammation and fibrosis, not
just a table.
9) Discussion, first paragraph: it’s mandatory to evaluate the correlation between
AFP and ALT, AST and Gamma-GT.
10) Discussion, first paragraph: it’s mandatory to evaluate the reproducibility of
AFP test dosages.
11) Discussion, first paragraph: the discussion about age and gender should be
included in the results not in the discussion.
12) Discussion, first paragraph: it is mandatory a multivariate analysis of age and
sex.
13) Discussion, fourth paragraph: it is unacceptable not include ALT values for
each patient, which is an inclusion criterion for the diagnosis of CHB as specified
in the text.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
Please review this paper.
user
Reviewer's report
Title:Alpha-Fetoprotein Level as a Biomarker of Liver Fibrosis Status in 621
consecutive patients with Chronic Hepatitis B
Version: 1Date:10 September 2013
Reviewer: Anna Pecorelli
Reviewer's report:
Major Compulsory Revisions:
1) Materials and Methods, Patients, second paragraph: there are few data about
study populations’ characteristics , for example: median value of ALT and AST,
percentage of obese patients or patients with metabolic syndrome, diabetes or
dislipedemia are included (these patients in fact could be affected by NASH
which can contribute to liver damage.)
2) Materials and Methods, Patients, second paragraph: how HCC has been
excluded? Which imaging techniques have been used? And which criteria has
been adopted?
3) Materials and Methods, Methods, Liver biopsy and histopathology, first
paragraph: it is no specified if biopsies were made by different clinicians.
Different experience could influence for example the length of the tissue
samples.
4) Materials and Methods, Methods, Liver biopsy and histopathology, first
paragraph: if possible specify the median length of tissue samples. 15 mm is too
small (a length of at least 25 mm is necessary to evaluate fibrosis accurately).
5) Results, Demographic characteristics, first paragraph: patients < 12 years old
should be excluded because the possible different behavior of AFP in child.
6) Results, Demographic characteristics, first paragraph: no data are available on
the HBV infection duration. Specify the median duration of CHB.
7) Results, Demographic characteristics, first paragraph: there are too many
patients in inflammation and fibrosis stage 3-4 (more than half).
8) Results, Correlation of AFP versus liver inflammation and fibrosis stage: insert
a figure with all values of AFP for each stage of inflammation and fibrosis, not
just a table.
9) Discussion, first paragraph: it’s mandatory to evaluate the correlation between
AFP and ALT, AST and Gamma-GT.
10) Discussion, first paragraph: it’s mandatory to evaluate the reproducibility of
AFP test dosages.
11) Discussion, first paragraph: the discussion about age and gender should be
included in the results not in the discussion.
12) Discussion, first paragraph: it is mandatory a multivariate analysis of age and
sex.
13) Discussion, fourth paragraph: it is unacceptable not include ALT values for
each patient, which is an inclusion criterion for the diagnosis of CHB as specified
in the text.
Level of interest: An article of limited interest
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests.
assistant