Reviewer ’s report  
Title: Low lymphocyte count and high monocyte count predicts poor prognosis of gastric cancer  
 
Version: 2 Date: 07 Aug 2018  
 
Reviewer: Theodoros Karantanos  
 
Reviewer's report:  
This is an interesting retr ospective study evaluating the impact of absolute number of peripheral 
blood cells in the prognosis of patients with gastric cancer. The authors showed that high 
neutrophils, monocytes and platelets and low lymphocytes are associated with worse prognosis 
in gastric cancer focusing on overall survival. Absolute lymphocytes and monocytes are the only 
independent factors. Absolute numbers are more useful than rates and I would agree that these 
correlations are important.  
 
I have only a few relatively minor po ints: 
 
1) Did the authors do any correlation with other outcomes (i.e Progression free survival), this 
may be particularly interesting in these patients with early disease? There is evidence that 
lymphocytes contribute to better GI tumors control following  surgery  
 
2) It seems that the predictive role of the absolute number of PBCs is important for stages II/III 
but not stage I. The number of stage I patients is not different to the stage II patients so I am 
wondering what is the explanation of this phenom enon by the authors?  
 
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.  
Unable to assess  
Are the conclusions drawn adequa tely 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommende d, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interest s 
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 pub lication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in 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 content 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 declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no com peting interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be pos ted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be inc luded 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: Low lymphocyte count and high monocyte count predicts poor prognosis of gastric cancer  
 
Version: 2 Date: 07 Aug 2018  
 
Reviewer: Theodoros Karantanos  
 
Reviewer's report:  
This is an interesting retr ospective study evaluating the impact of absolute number of peripheral 
blood cells in the prognosis of patients with gastric cancer. The authors showed that high 
neutrophils, monocytes and platelets and low lymphocytes are associated with worse prognosis 
in gastric cancer focusing on overall survival. Absolute lymphocytes and monocytes are the only 
independent factors. Absolute numbers are more useful than rates and I would agree that these 
correlations are important.  
 
I have only a few relatively minor po ints: 
 
1) Did the authors do any correlation with other outcomes (i.e Progression free survival), this 
may be particularly interesting in these patients with early disease? There is evidence that 
lymphocytes contribute to better GI tumors control following  surgery  
 
2) It seems that the predictive role of the absolute number of PBCs is important for stages II/III 
but not stage I. The number of stage I patients is not different to the stage II patients so I am 
wondering what is the explanation of this phenom enon by the authors?  
 
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.  
Unable to assess  
Are the conclusions drawn adequa tely 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommende d, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interest s 
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 pub lication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in 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 content 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 declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no com peting interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be pos ted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be inc luded 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: Low lymphocyte count and high monocyte count predicts poor prognosis of gastric cancer  
 
Version: 2 Date: 07 Aug 2018  
 
Reviewer: Theodoros Karantanos  
 
Reviewer's report:  
This is an interesting retr ospective study evaluating the impact of absolute number of peripheral 
blood cells in the prognosis of patients with gastric cancer. The authors showed that high 
neutrophils, monocytes and platelets and low lymphocytes are associated with worse prognosis 
in gastric cancer focusing on overall survival. Absolute lymphocytes and monocytes are the only 
independent factors. Absolute numbers are more useful than rates and I would agree that these 
correlations are important.  
 
I have only a few relatively minor po ints: 
 
1) Did the authors do any correlation with other outcomes (i.e Progression free survival), this 
may be particularly interesting in these patients with early disease? There is evidence that 
lymphocytes contribute to better GI tumors control following  surgery  
 
2) It seems that the predictive role of the absolute number of PBCs is important for stages II/III 
but not stage I. The number of stage I patients is not different to the stage II patients so I am 
wondering what is the explanation of this phenom enon by the authors?  
 
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.  
Unable to assess  
Are the conclusions drawn adequa tely 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 manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommende d, please speci fy what aspects require further 
assessment in your comments to the editors.  
I am able to assess the statistics  
Quality of written English  
Please indicate the quality of language in the manuscript:  
Acceptable  
Declaration of competing interest s 
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 pub lication of this 
manuscript, either now or in the future?  
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either now or in 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 content 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 declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no com peting interests  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will be pos ted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be inc luded 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