Reviewer’s report
Title: 
Evaluation of serum ATX and LPA as potential diagnostic biomarkers in
patients with pancreatic cancer
Version: 
1 
Date: 
07 Feb 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
The manuscript entitled Evaluation of serum ATX and LPA as potential
diagnostic biomarkers in patients with pancreatic cancer present interesting data
concerning new biomarkers for pancreatic cancer (PC).
I find the manuscript interesting and of scientific value. I have some minor
comments.
Overall: The authors sometimes use prognostic marker instead of diagnostic
marker the manuscript. Use diagnostic marker consequently.
Most of the references are quite old although there are more recent studies about
LPA and ATX in pancreatic cancer. Please include some more recent findings
shortly in background and/or discussion.
Methods:
How was patient characteristics like "High sugar diet" and "Alcohol" defined?
How was this information retrieved for the study?
Was Pearson Product Moment used? Where are the results from this analysis
described? In methods, statistical analysis it is written that data should be shown
with median and range in the tables, however, in the tables mean and standard
error of the mean is used. Please change to median and range.
Results: 
page 9, there is an incorrect p value (p<0.642) in the beginning of section
"Biochemical parameters for healthy volunteers, PC patients, and BPD patients"
page 10, If values are given in tables please don´t write the same values in the
text. Table is to prefer. The figure 995.47 (for Ca19-9) is not the same as in the
table- which value is correct?
Discussion:
Page 14 when discussing sensitivity and specificity it must be written out that
this is a post hoc test (since the cut offs are decided from this same population).
Please don´t compare the sensitivity and specificity as in 
the sentence
"Interestingly, LPA had higher
sensitivity (91.74%) but lower specificity (69.4%) for detection of PC from
among the total study population." since this is depending on the cut offs which
you decided. With other cut offs these values will change. It is more correct to
compare the AUC of the ROC curves.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
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.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional 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 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 competing 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
posted 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 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: 
Evaluation of serum ATX and LPA as potential diagnostic biomarkers in
patients with pancreatic cancer
Version: 
1 
Date: 
07 Feb 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
The manuscript entitled Evaluation of serum ATX and LPA as potential
diagnostic biomarkers in patients with pancreatic cancer present interesting data
concerning new biomarkers for pancreatic cancer (PC).
I find the manuscript interesting and of scientific value. I have some minor
comments.
Overall: The authors sometimes use prognostic marker instead of diagnostic
marker the manuscript. Use diagnostic marker consequently.
Most of the references are quite old although there are more recent studies about
LPA and ATX in pancreatic cancer. Please include some more recent findings
shortly in background and/or discussion.
Methods:
How was patient characteristics like "High sugar diet" and "Alcohol" defined?
How was this information retrieved for the study?
Was Pearson Product Moment used? Where are the results from this analysis
described? In methods, statistical analysis it is written that data should be shown
with median and range in the tables, however, in the tables mean and standard
error of the mean is used. Please change to median and range.
Results: 
page 9, there is an incorrect p value (p<0.642) in the beginning of section
"Biochemical parameters for healthy volunteers, PC patients, and BPD patients"
page 10, If values are given in tables please don´t write the same values in the
text. Table is to prefer. The figure 995.47 (for Ca19-9) is not the same as in the
table- which value is correct?
Discussion:
Page 14 when discussing sensitivity and specificity it must be written out that
this is a post hoc test (since the cut offs are decided from this same population).
Please don´t compare the sensitivity and specificity as in 
the sentence
"Interestingly, LPA had higher
sensitivity (91.74%) but lower specificity (69.4%) for detection of PC from
among the total study population." since this is depending on the cut offs which
you decided. With other cut offs these values will change. It is more correct to
compare the AUC of the ROC curves.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
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.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional 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 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 competing 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
posted 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 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: 
Evaluation of serum ATX and LPA as potential diagnostic biomarkers in
patients with pancreatic cancer
Version: 
1 
Date: 
07 Feb 2020
Reviewer's report:
Please include all comments for the authors in this box rather than uploading
your report as an attachment. Please only upload as attachments annotated
versions of manuscripts, graphs, supporting materials or other aspects of your
report which cannot be included in a text format.
Please overwrite this text when adding your comments to the authors.
The manuscript entitled Evaluation of serum ATX and LPA as potential
diagnostic biomarkers in patients with pancreatic cancer present interesting data
concerning new biomarkers for pancreatic cancer (PC).
I find the manuscript interesting and of scientific value. I have some minor
comments.
Overall: The authors sometimes use prognostic marker instead of diagnostic
marker the manuscript. Use diagnostic marker consequently.
Most of the references are quite old although there are more recent studies about
LPA and ATX in pancreatic cancer. Please include some more recent findings
shortly in background and/or discussion.
Methods:
How was patient characteristics like "High sugar diet" and "Alcohol" defined?
How was this information retrieved for the study?
Was Pearson Product Moment used? Where are the results from this analysis
described? In methods, statistical analysis it is written that data should be shown
with median and range in the tables, however, in the tables mean and standard
error of the mean is used. Please change to median and range.
Results: 
page 9, there is an incorrect p value (p<0.642) in the beginning of section
"Biochemical parameters for healthy volunteers, PC patients, and BPD patients"
page 10, If values are given in tables please don´t write the same values in the
text. Table is to prefer. The figure 995.47 (for Ca19-9) is not the same as in the
table- which value is correct?
Discussion:
Page 14 when discussing sensitivity and specificity it must be written out that
this is a post hoc test (since the cut offs are decided from this same population).
Please don´t compare the sensitivity and specificity as in 
the sentence
"Interestingly, LPA had higher
sensitivity (91.74%) but lower specificity (69.4%) for detection of PC from
among the total study population." since this is depending on the cut offs which
you decided. With other cut offs these values will change. It is more correct to
compare the AUC of the ROC curves.
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
No
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.
No
Are you able to assess any statistics in the manuscript or would you
recommend an additional statistical review?
If an additional 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 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 competing 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
posted 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 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