Reviewer ’s report  
 
Title: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of 
gallstone pancreatitis  
 
Version: 0 Date: 19 Nov 2017  
 
Reviewer: Joachim Mertens  
 
Reviewer's report:  
 
The manuscript (BMGE -D-17-00463) examines the predictive value of neutrophil to lymphocyte 
ratio (NL R) and platelet to lymphocyte ratio (PLR) in acute pancreatitis (AP) of alcoholic or 
biliary origin.  
The data of 243 patients enrolled in this study were collected prospectively in a tertiary center in 
Korea. NLR and PLR were compared to established AP se verity scores and predictive lab values.  
The topic of the present manuscript is interesting and novel as PLR has so far not been 
investigated as a predictive value in AP. Many of the currently available predictive scores in AP 
are cumbersome and of limit ed prognostic value. Therefore, an easy and reliable parameter is 
desirable.  
 
The methodology seems straightforward albeit the number of included patients is rather small.  
Analysis of NLR and PLR in alcoholic and biliary AP showed significance for severe c ourses of 
disease only in biliary AP but not in alcoholic. The significantly higher rate of cirrhotics in the 
alcoholic group and possible related thrombopenia may explain differences in the PLR in this 
group. This needs to be addressed in the discussion.  
The resolution of figure 2 makes review almost impossible.  
 
MAJOR COMMENTS:  
1) The issue of liver disease related thrombopenia needs to be addressed in the discussion as 
this may influence PLR in the alcoholic AP group of patients.  
 
MINOR COMMENTS:  
Resolut ion of figure 2 is very low. Please review this figure  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an addition al statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any  way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or i n the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the c ontent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I dec lare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my re port to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Crea tive Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of 
gallstone pancreatitis  
 
Version: 0 Date: 19 Nov 2017  
 
Reviewer: Joachim Mertens  
 
Reviewer's report:  
 
The manuscript (BMGE -D-17-00463) examines the predictive value of neutrophil to lymphocyte 
ratio (NL R) and platelet to lymphocyte ratio (PLR) in acute pancreatitis (AP) of alcoholic or 
biliary origin.  
The data of 243 patients enrolled in this study were collected prospectively in a tertiary center in 
Korea. NLR and PLR were compared to established AP se verity scores and predictive lab values.  
The topic of the present manuscript is interesting and novel as PLR has so far not been 
investigated as a predictive value in AP. Many of the currently available predictive scores in AP 
are cumbersome and of limit ed prognostic value. Therefore, an easy and reliable parameter is 
desirable.  
 
The methodology seems straightforward albeit the number of included patients is rather small.  
Analysis of NLR and PLR in alcoholic and biliary AP showed significance for severe c ourses of 
disease only in biliary AP but not in alcoholic. The significantly higher rate of cirrhotics in the 
alcoholic group and possible related thrombopenia may explain differences in the PLR in this 
group. This needs to be addressed in the discussion.  
The resolution of figure 2 makes review almost impossible.  
 
MAJOR COMMENTS:  
1) The issue of liver disease related thrombopenia needs to be addressed in the discussion as 
this may influence PLR in the alcoholic AP group of patients.  
 
MINOR COMMENTS:  
Resolut ion of figure 2 is very low. Please review this figure  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an addition al statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any  way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or i n the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the c ontent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I dec lare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my re port to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Crea tive Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of 
gallstone pancreatitis  
 
Version: 0 Date: 19 Nov 2017  
 
Reviewer: Joachim Mertens  
 
Reviewer's report:  
 
The manuscript (BMGE -D-17-00463) examines the predictive value of neutrophil to lymphocyte 
ratio (NL R) and platelet to lymphocyte ratio (PLR) in acute pancreatitis (AP) of alcoholic or 
biliary origin.  
The data of 243 patients enrolled in this study were collected prospectively in a tertiary center in 
Korea. NLR and PLR were compared to established AP se verity scores and predictive lab values.  
The topic of the present manuscript is interesting and novel as PLR has so far not been 
investigated as a predictive value in AP. Many of the currently available predictive scores in AP 
are cumbersome and of limit ed prognostic value. Therefore, an easy and reliable parameter is 
desirable.  
 
The methodology seems straightforward albeit the number of included patients is rather small.  
Analysis of NLR and PLR in alcoholic and biliary AP showed significance for severe c ourses of 
disease only in biliary AP but not in alcoholic. The significantly higher rate of cirrhotics in the 
alcoholic group and possible related thrombopenia may explain differences in the PLR in this 
group. This needs to be addressed in the discussion.  
The resolution of figure 2 makes review almost impossible.  
 
MAJOR COMMENTS:  
1) The issue of liver disease related thrombopenia needs to be addressed in the discussion as 
this may influence PLR in the alcoholic AP group of patients.  
 
MINOR COMMENTS:  
Resolut ion of figure 2 is very low. Please review this figure  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an addition al statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any  way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or i n the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the c ontent of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I dec lare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests'  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my re port to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Crea tive Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant