Reviewer ’s report  
 
Title: Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio can predict the severity of 
gallstone pancreatitis  
 
Version: 0 Date: 27 Oct 2017  
 
Reviewer: Claudio Luchini  
 
Reviewer's report:  
 
I have read with great interest this manuscript abou t a very important topic, of importance in 
surgery as well as in laboratory medicine and pathology.  
This paper is well written, well presented and, above all, with important results.  
I have only minor revisions to suggest before publication, congratulations to the Authors.  
 
Here my points:  
1. Please discuss your findings also in light of this paper. I suggest to add at least 4 -5 sentences 
since this point is very important (inflammation  - cancer - biomarkers). Neutrophil -to-
lymphocyte Ratio is a Predictive Marker for Invasive Malignancy in Intraductal Papillary 
Mucinous Neoplasms of the Pancreas. Gemenetzis G, et al. Ann Surg. 2017 
Aug;266(2):339 -345. 
2. Please discuss also the topic of the potential application of such or similar methods to 
autoimmune pancreatitis.  
3. The Authors stated: "The diagnosis of AP was based on presence of 2 of the following 3 
criteria: typical abdominal pain; serum amylase or lipase elevation ≥ 3 times the upp er limit 
of normal; characteristic findings of AP on contrast -enhanced computed tomography, 
magnetic resonance imaging, or abdominal ultrasonography". Please use international 
criteria for the diagnosis and indicate these criteria clearly; it is not accept able writing that 
the diagnosis was based on…..you have to indicate the reference that support this diagnosis 
and the method used, in this way it appears a subjective method to make the diagnosis.  
4. The Authors did not explain why their results are valid in only in gallstone AP only. I accept 
the fact that now it is not possible to provide all the reasons but the discussion on this point 
is not sufficient. The Authors should discuss more in depth this point and all the possible 
reasons, also expanding the references and better studying the pre -existing literature on the 
difference between alcohol and gallstone AP.  
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 th e 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 additional statistical review is recommended, please specify 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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five yea rs 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, fundin g, 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 yo u 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 u nderstand 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 repor t 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 e ditors, 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: 27 Oct 2017  
 
Reviewer: Claudio Luchini  
 
Reviewer's report:  
 
I have read with great interest this manuscript abou t a very important topic, of importance in 
surgery as well as in laboratory medicine and pathology.  
This paper is well written, well presented and, above all, with important results.  
I have only minor revisions to suggest before publication, congratulations to the Authors.  
 
Here my points:  
1. Please discuss your findings also in light of this paper. I suggest to add at least 4 -5 sentences 
since this point is very important (inflammation  - cancer - biomarkers). Neutrophil -to-
lymphocyte Ratio is a Predictive Marker for Invasive Malignancy in Intraductal Papillary 
Mucinous Neoplasms of the Pancreas. Gemenetzis G, et al. Ann Surg. 2017 
Aug;266(2):339 -345. 
2. Please discuss also the topic of the potential application of such or similar methods to 
autoimmune pancreatitis.  
3. The Authors stated: "The diagnosis of AP was based on presence of 2 of the following 3 
criteria: typical abdominal pain; serum amylase or lipase elevation ≥ 3 times the upp er limit 
of normal; characteristic findings of AP on contrast -enhanced computed tomography, 
magnetic resonance imaging, or abdominal ultrasonography". Please use international 
criteria for the diagnosis and indicate these criteria clearly; it is not accept able writing that 
the diagnosis was based on…..you have to indicate the reference that support this diagnosis 
and the method used, in this way it appears a subjective method to make the diagnosis.  
4. The Authors did not explain why their results are valid in only in gallstone AP only. I accept 
the fact that now it is not possible to provide all the reasons but the discussion on this point 
is not sufficient. The Authors should discuss more in depth this point and all the possible 
reasons, also expanding the references and better studying the pre -existing literature on the 
difference between alcohol and gallstone AP.  
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 th e 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 additional statistical review is recommended, please specify 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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five yea rs 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, fundin g, 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 yo u 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 u nderstand 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 repor t 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 e ditors, 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: 27 Oct 2017  
 
Reviewer: Claudio Luchini  
 
Reviewer's report:  
 
I have read with great interest this manuscript abou t a very important topic, of importance in 
surgery as well as in laboratory medicine and pathology.  
This paper is well written, well presented and, above all, with important results.  
I have only minor revisions to suggest before publication, congratulations to the Authors.  
 
Here my points:  
1. Please discuss your findings also in light of this paper. I suggest to add at least 4 -5 sentences 
since this point is very important (inflammation  - cancer - biomarkers). Neutrophil -to-
lymphocyte Ratio is a Predictive Marker for Invasive Malignancy in Intraductal Papillary 
Mucinous Neoplasms of the Pancreas. Gemenetzis G, et al. Ann Surg. 2017 
Aug;266(2):339 -345. 
2. Please discuss also the topic of the potential application of such or similar methods to 
autoimmune pancreatitis.  
3. The Authors stated: "The diagnosis of AP was based on presence of 2 of the following 3 
criteria: typical abdominal pain; serum amylase or lipase elevation ≥ 3 times the upp er limit 
of normal; characteristic findings of AP on contrast -enhanced computed tomography, 
magnetic resonance imaging, or abdominal ultrasonography". Please use international 
criteria for the diagnosis and indicate these criteria clearly; it is not accept able writing that 
the diagnosis was based on…..you have to indicate the reference that support this diagnosis 
and the method used, in this way it appears a subjective method to make the diagnosis.  
4. The Authors did not explain why their results are valid in only in gallstone AP only. I accept 
the fact that now it is not possible to provide all the reasons but the discussion on this point 
is not sufficient. The Authors should discuss more in depth this point and all the possible 
reasons, also expanding the references and better studying the pre -existing literature on the 
difference between alcohol and gallstone AP.  
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 th e 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 additional statistical review is recommended, please specify 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:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five yea rs 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, fundin g, 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 yo u 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 u nderstand 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 repor t 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 e ditors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant