Reviewer's report
Title:Detection of serum MMP-7 and MMP-9 in cholangiocarcinoma patients:
evaluation of diagnostic accuracy
Version: 2Date:16 February 2009
Reviewer: Stanley Zucker
Reviewer's report:
Review
This is a well written manuscript using state of the art approaches to address a
reasonable problem in clinical medicine relating to difficulty in diagnosis of
cholangitic carcinoma. The MMP-7 data is of interest and is deserving of
publication.
Major Compulsory Revisions
1. A major problem in technique in this manuscript relates to the concept of
measuring MMP-9 in blood using serum specimens. There have been numerous
publications describing the fact that most of the MMP-9 identified in serum
specimens is an artefact representing the release of MMP-9 from neutrophils
during the clotting process rather than from diseased tissues. To properly
measure MMP-9 in blood, the specimen should be anti-coagulated during blood
collection and plasma should be isolated without delay. This oversight has led to
many reports of elevated serum MMP-9 levels in various diseases and although
the results might appear relevant, the conclusions are based on erroneous
assumption. Nonetheless if the authors add this type of information to the
Discussion of their manuscript with appropriate references, it would be
reasonable to leave the MMP-9 data in the manuscript. Fortunately,
measurement of MMP-7 in serum specimens does not suffer the same artefact
as MMP-9.
2. The authors should clarify the issue of whether the serum MMP-7 will actually
be useful to clinicians in making decisions regarding patient care. I believe that
they have overstated their case. Although the authors correctly point out that the
specificity and sensitivity of MMP-7 measurement provides some predictive
power, they should address the practical issue of how clinicians may be able to
use the test in the current setting of a routine clinical labs. How variable will the
cut off levels for “normal” be between different labs? Do they think the test is
important enough to request that regulatory agencies approve the test for clinical
applications?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests' below
Reviewer's report
Title:Detection of serum MMP-7 and MMP-9 in cholangiocarcinoma patients:
evaluation of diagnostic accuracy
Version: 2Date:16 February 2009
Reviewer: Stanley Zucker
Reviewer's report:
Review
This is a well written manuscript using state of the art approaches to address a
reasonable problem in clinical medicine relating to difficulty in diagnosis of
cholangitic carcinoma. The MMP-7 data is of interest and is deserving of
publication.
Major Compulsory Revisions
1. A major problem in technique in this manuscript relates to the concept of
measuring MMP-9 in blood using serum specimens. There have been numerous
publications describing the fact that most of the MMP-9 identified in serum
specimens is an artefact representing the release of MMP-9 from neutrophils
during the clotting process rather than from diseased tissues. To properly
measure MMP-9 in blood, the specimen should be anti-coagulated during blood
collection and plasma should be isolated without delay. This oversight has led to
many reports of elevated serum MMP-9 levels in various diseases and although
the results might appear relevant, the conclusions are based on erroneous
assumption. Nonetheless if the authors add this type of information to the
Discussion of their manuscript with appropriate references, it would be
reasonable to leave the MMP-9 data in the manuscript. Fortunately,
measurement of MMP-7 in serum specimens does not suffer the same artefact
as MMP-9.
2. The authors should clarify the issue of whether the serum MMP-7 will actually
be useful to clinicians in making decisions regarding patient care. I believe that
they have overstated their case. Although the authors correctly point out that the
specificity and sensitivity of MMP-7 measurement provides some predictive
power, they should address the practical issue of how clinicians may be able to
use the test in the current setting of a routine clinical labs. How variable will the
cut off levels for “normal” be between different labs? Do they think the test is
important enough to request that regulatory agencies approve the test for clinical
applications?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests' below
Please review this paper.
user
Reviewer's report
Title:Detection of serum MMP-7 and MMP-9 in cholangiocarcinoma patients:
evaluation of diagnostic accuracy
Version: 2Date:16 February 2009
Reviewer: Stanley Zucker
Reviewer's report:
Review
This is a well written manuscript using state of the art approaches to address a
reasonable problem in clinical medicine relating to difficulty in diagnosis of
cholangitic carcinoma. The MMP-7 data is of interest and is deserving of
publication.
Major Compulsory Revisions
1. A major problem in technique in this manuscript relates to the concept of
measuring MMP-9 in blood using serum specimens. There have been numerous
publications describing the fact that most of the MMP-9 identified in serum
specimens is an artefact representing the release of MMP-9 from neutrophils
during the clotting process rather than from diseased tissues. To properly
measure MMP-9 in blood, the specimen should be anti-coagulated during blood
collection and plasma should be isolated without delay. This oversight has led to
many reports of elevated serum MMP-9 levels in various diseases and although
the results might appear relevant, the conclusions are based on erroneous
assumption. Nonetheless if the authors add this type of information to the
Discussion of their manuscript with appropriate references, it would be
reasonable to leave the MMP-9 data in the manuscript. Fortunately,
measurement of MMP-7 in serum specimens does not suffer the same artefact
as MMP-9.
2. The authors should clarify the issue of whether the serum MMP-7 will actually
be useful to clinicians in making decisions regarding patient care. I believe that
they have overstated their case. Although the authors correctly point out that the
specificity and sensitivity of MMP-7 measurement provides some predictive
power, they should address the practical issue of how clinicians may be able to
use the test in the current setting of a routine clinical labs. How variable will the
cut off levels for “normal” be between different labs? Do they think the test is
important enough to request that regulatory agencies approve the test for clinical
applications?
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests' below
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