Title: Platelet-to-High-Density Lipoprotein Ratio (PHR) as a Predictive Biomarker for
Gastrointestinal Cancers: Evidence from NHANES
Version: 1 Date: 28 Feb 2025
Reviewer:  Yasmin Guerreiro Nagashima
Reviewer's report:
I have reviewed this study and offer the following observations:
Methods Section:
It was not specified whether the use of medications was considered, nor whether such use could
affect platelet counts or HDL levels.
Results Section (Education Levels):
When reporting that there were 28 participants with less than a 9th grade education and 41
participants with a 9th–11th grade education, the use of ‘OR’ remains unclear—specifically, it is
not evident whether this value represents a combined total, given that the number of participants
classified as ‘college graduate or above’ was 34.
Results Section (PIR):
Regarding the PIR, it is unclear how the finding that PIR<= 1 was observed in 39 cancer patients
is interpreted as more prevalent than the 116 cancer patients with PIR values in the 1–3 range.
Discussion Section (Fourth Paragraph–Healthy Fats):
“Similarly, strategies to improve HDL-C levels, such as increased physical activity,
consumption of healthy fats, and the use of lipid-lowering therapies, may offer additional
protective benefits.”
It is recommended that when referring to ‘healthy fats’, the authors either provide specific
examples (e.g., omega-3 fatty acids) or clarify the terminology to enhance reader understanding.
Discussion Section (Fifth Paragraph–Detailed Tumor Characteristics):
“The study also did not account for potential confounders such as dietary patterns,
genetic predispositions, or detailed tumor characteristics, which could influence the observed
associations.”
Here, “detailed tumor characteristics” may imply that information regarding tumor staging was
not accessible, a factor that could significantly impact the results.
Title: Platelet-to-High-Density Lipoprotein Ratio (PHR) as a Predictive Biomarker for
Gastrointestinal Cancers: Evidence from NHANES
Version: 1 Date: 28 Feb 2025
Reviewer:  Yasmin Guerreiro Nagashima
Reviewer's report:
I have reviewed this study and offer the following observations:
Methods Section:
It was not specified whether the use of medications was considered, nor whether such use could
affect platelet counts or HDL levels.
Results Section (Education Levels):
When reporting that there were 28 participants with less than a 9th grade education and 41
participants with a 9th–11th grade education, the use of ‘OR’ remains unclear—specifically, it is
not evident whether this value represents a combined total, given that the number of participants
classified as ‘college graduate or above’ was 34.
Results Section (PIR):
Regarding the PIR, it is unclear how the finding that PIR<= 1 was observed in 39 cancer patients
is interpreted as more prevalent than the 116 cancer patients with PIR values in the 1–3 range.
Discussion Section (Fourth Paragraph–Healthy Fats):
“Similarly, strategies to improve HDL-C levels, such as increased physical activity,
consumption of healthy fats, and the use of lipid-lowering therapies, may offer additional
protective benefits.”
It is recommended that when referring to ‘healthy fats’, the authors either provide specific
examples (e.g., omega-3 fatty acids) or clarify the terminology to enhance reader understanding.
Discussion Section (Fifth Paragraph–Detailed Tumor Characteristics):
“The study also did not account for potential confounders such as dietary patterns,
genetic predispositions, or detailed tumor characteristics, which could influence the observed
associations.”
Here, “detailed tumor characteristics” may imply that information regarding tumor staging was
not accessible, a factor that could significantly impact the results.
Please review this paper.
user
Title: Platelet-to-High-Density Lipoprotein Ratio (PHR) as a Predictive Biomarker for
Gastrointestinal Cancers: Evidence from NHANES
Version: 1 Date: 28 Feb 2025
Reviewer:  Yasmin Guerreiro Nagashima
Reviewer's report:
I have reviewed this study and offer the following observations:
Methods Section:
It was not specified whether the use of medications was considered, nor whether such use could
affect platelet counts or HDL levels.
Results Section (Education Levels):
When reporting that there were 28 participants with less than a 9th grade education and 41
participants with a 9th–11th grade education, the use of ‘OR’ remains unclear—specifically, it is
not evident whether this value represents a combined total, given that the number of participants
classified as ‘college graduate or above’ was 34.
Results Section (PIR):
Regarding the PIR, it is unclear how the finding that PIR<= 1 was observed in 39 cancer patients
is interpreted as more prevalent than the 116 cancer patients with PIR values in the 1–3 range.
Discussion Section (Fourth Paragraph–Healthy Fats):
“Similarly, strategies to improve HDL-C levels, such as increased physical activity,
consumption of healthy fats, and the use of lipid-lowering therapies, may offer additional
protective benefits.”
It is recommended that when referring to ‘healthy fats’, the authors either provide specific
examples (e.g., omega-3 fatty acids) or clarify the terminology to enhance reader understanding.
Discussion Section (Fifth Paragraph–Detailed Tumor Characteristics):
“The study also did not account for potential confounders such as dietary patterns,
genetic predispositions, or detailed tumor characteristics, which could influence the observed
associations.”
Here, “detailed tumor characteristics” may imply that information regarding tumor staging was
not accessible, a factor that could significantly impact the results.
assistant