Title: Prediction of post-ESD Esophageal Stricture by a Nomogram and Risk Factor analysis
of Ineffective Oral Steroids Prophylaxis
Version: 3 Date: 29 Aug 2024
Reviewer:  Yasuaki Nagami
Reviewer's report:
This is a single-center retrospective study that evaluated stenosis prediction, The score for
each risk factor, Risk factors of ineffective oral steroid prophylaxis , and glucocorticoid
receptor expressions . Author concluded In the high-risk group with a circumferential mucosal
defect involving 7/8 or more, oral steroid treatment tends to be ineffective. The higher
glucocorticoid receptor # may indicate potential glucocorticoid resistance, possibly participating
in the ineffective treatment..
Nice study, but I have some comments.
Major Comments
1. I think this study is complicated because multiple outcomes in different group of patients. I
recommend you reduce outcomes in patients with oral steroid.
2. I think you should evaluate prediction model in patients with or without perophylactic
treatment. Or you should include and analyze steroid therapy in multivariate analysis. From table
1, steroid therapy wasn’t analyzed by multivariate analysis, was it?
3. How did you select factors to analyze multivariate analysis. Please describe it.
4. From Table 3, maximum score point seems to be 7 (location 2, circum 4, diameter 1). But,
you showed 9 point in bottom of Table 3. Please show how to use it.
5.  Please show how you take specimens for immunohistochemistry. If you used ESD specimen,
biopsy specimen before treatment is enough for examining those? Because we want to know
that information before treatment. Please add it to limitations.
6.
Title: Prediction of post-ESD Esophageal Stricture by a Nomogram and Risk Factor analysis
of Ineffective Oral Steroids Prophylaxis
Version: 3 Date: 29 Aug 2024
Reviewer:  Yasuaki Nagami
Reviewer's report:
This is a single-center retrospective study that evaluated stenosis prediction, The score for
each risk factor, Risk factors of ineffective oral steroid prophylaxis , and glucocorticoid
receptor expressions . Author concluded In the high-risk group with a circumferential mucosal
defect involving 7/8 or more, oral steroid treatment tends to be ineffective. The higher
glucocorticoid receptor # may indicate potential glucocorticoid resistance, possibly participating
in the ineffective treatment..
Nice study, but I have some comments.
Major Comments
1. I think this study is complicated because multiple outcomes in different group of patients. I
recommend you reduce outcomes in patients with oral steroid.
2. I think you should evaluate prediction model in patients with or without perophylactic
treatment. Or you should include and analyze steroid therapy in multivariate analysis. From table
1, steroid therapy wasn’t analyzed by multivariate analysis, was it?
3. How did you select factors to analyze multivariate analysis. Please describe it.
4. From Table 3, maximum score point seems to be 7 (location 2, circum 4, diameter 1). But,
you showed 9 point in bottom of Table 3. Please show how to use it.
5.  Please show how you take specimens for immunohistochemistry. If you used ESD specimen,
biopsy specimen before treatment is enough for examining those? Because we want to know
that information before treatment. Please add it to limitations.
6.
Please review this paper.
user
Title: Prediction of post-ESD Esophageal Stricture by a Nomogram and Risk Factor analysis
of Ineffective Oral Steroids Prophylaxis
Version: 3 Date: 29 Aug 2024
Reviewer:  Yasuaki Nagami
Reviewer's report:
This is a single-center retrospective study that evaluated stenosis prediction, The score for
each risk factor, Risk factors of ineffective oral steroid prophylaxis , and glucocorticoid
receptor expressions . Author concluded In the high-risk group with a circumferential mucosal
defect involving 7/8 or more, oral steroid treatment tends to be ineffective. The higher
glucocorticoid receptor # may indicate potential glucocorticoid resistance, possibly participating
in the ineffective treatment..
Nice study, but I have some comments.
Major Comments
1. I think this study is complicated because multiple outcomes in different group of patients. I
recommend you reduce outcomes in patients with oral steroid.
2. I think you should evaluate prediction model in patients with or without perophylactic
treatment. Or you should include and analyze steroid therapy in multivariate analysis. From table
1, steroid therapy wasn’t analyzed by multivariate analysis, was it?
3. How did you select factors to analyze multivariate analysis. Please describe it.
4. From Table 3, maximum score point seems to be 7 (location 2, circum 4, diameter 1). But,
you showed 9 point in bottom of Table 3. Please show how to use it.
5.  Please show how you take specimens for immunohistochemistry. If you used ESD specimen,
biopsy specimen before treatment is enough for examining those? Because we want to know
that information before treatment. Please add it to limitations.
6.
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