Reviewer's report
Title:Heat Shock Protein-27, -60 and -90 expression in gastric cancer:
association with clinicopathological variables and patient survival
Version: 1Date:28 May 2008
Reviewer: Oliver Stoeltzing
Reviewer's report:
The study by Giaginis et al. “Heat Shock Protein-27, -60 and -90 expression in
gastric cancer: association with clinicopathological variables and patient survival”
investigated the expression of distinct HSPs, which are being implicated in
cancer progression, in human tissues of gastric adenocarcinomas. The authors
found that HSP-27, HSP-60, HSP-90 proteins were expressed in gastric
adenocarcinoma specimens. Expression of HSP-27 was significantly associated
with tumor size and the presence of organ metastasis. HSP-90 expression was
not associated with any of the clinicopathological parameters. Surprisingly, high
HSP-90 expression was significantly associated with longer overall survival
times.
Interesting study, especially the fact that Hsp90 expression is associated with an
improved survival is somewhat intriguing. This finding actually demands further
attention, as it could imply that loss of chaperoning (i.e. Hsp90) leads to a more
aggressive phenotype, hence leading to poor prognosis (and resistance to
therapy?). The paper would therefore substantially be improved if authors could
provide data on differences in Hsp90 client protein expression (HER2, EGFR?...)
in these tissues.
Specific comments: Minor Essential Revisions
1. Methods: it is not clear what authors mean with “expression” versus “staining
intensity”, and the relevance of this distinction. Why were two rating systems
applied? I strongly suggest using only one rating system and performing
adequate analysis of relevant variables. In addition, the rationale for the arbitrary
cut-off threshold for Hsp expression (52% vs 48%) is not clear. The authors need
to explain,, or refine this threshold in terms of using one cut-off value throughout
the manuscript (i..e. 50%?).
2. Significant data on “sex” and “age” do not appear to be important variables,
otherwise authors need to explain why this finding is really clinically relevant. I
would suggest omitting these data.
3. What is the clinical significance of Hsp60 expression? This remains unclear. In
addition, Ki-67 staining does not provide any significant information as it does not
correlate with staining. This needs to be addressed or omitted.
4. Tables are very large and contain too many non-relevant data. Authors should
focus and revise. (again using one rating system is sufficient).
5. Figure 1: this figure should be optimized in terms of presenting staining of
normal and tumor tissues of both intestinal and diffuse type cancers, and at two
magnifications (inserts).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:Heat Shock Protein-27, -60 and -90 expression in gastric cancer:
association with clinicopathological variables and patient survival
Version: 1Date:28 May 2008
Reviewer: Oliver Stoeltzing
Reviewer's report:
The study by Giaginis et al. “Heat Shock Protein-27, -60 and -90 expression in
gastric cancer: association with clinicopathological variables and patient survival”
investigated the expression of distinct HSPs, which are being implicated in
cancer progression, in human tissues of gastric adenocarcinomas. The authors
found that HSP-27, HSP-60, HSP-90 proteins were expressed in gastric
adenocarcinoma specimens. Expression of HSP-27 was significantly associated
with tumor size and the presence of organ metastasis. HSP-90 expression was
not associated with any of the clinicopathological parameters. Surprisingly, high
HSP-90 expression was significantly associated with longer overall survival
times.
Interesting study, especially the fact that Hsp90 expression is associated with an
improved survival is somewhat intriguing. This finding actually demands further
attention, as it could imply that loss of chaperoning (i.e. Hsp90) leads to a more
aggressive phenotype, hence leading to poor prognosis (and resistance to
therapy?). The paper would therefore substantially be improved if authors could
provide data on differences in Hsp90 client protein expression (HER2, EGFR?...)
in these tissues.
Specific comments: Minor Essential Revisions
1. Methods: it is not clear what authors mean with “expression” versus “staining
intensity”, and the relevance of this distinction. Why were two rating systems
applied? I strongly suggest using only one rating system and performing
adequate analysis of relevant variables. In addition, the rationale for the arbitrary
cut-off threshold for Hsp expression (52% vs 48%) is not clear. The authors need
to explain,, or refine this threshold in terms of using one cut-off value throughout
the manuscript (i..e. 50%?).
2. Significant data on “sex” and “age” do not appear to be important variables,
otherwise authors need to explain why this finding is really clinically relevant. I
would suggest omitting these data.
3. What is the clinical significance of Hsp60 expression? This remains unclear. In
addition, Ki-67 staining does not provide any significant information as it does not
correlate with staining. This needs to be addressed or omitted.
4. Tables are very large and contain too many non-relevant data. Authors should
focus and revise. (again using one rating system is sufficient).
5. Figure 1: this figure should be optimized in terms of presenting staining of
normal and tumor tissues of both intestinal and diffuse type cancers, and at two
magnifications (inserts).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:Heat Shock Protein-27, -60 and -90 expression in gastric cancer:
association with clinicopathological variables and patient survival
Version: 1Date:28 May 2008
Reviewer: Oliver Stoeltzing
Reviewer's report:
The study by Giaginis et al. “Heat Shock Protein-27, -60 and -90 expression in
gastric cancer: association with clinicopathological variables and patient survival”
investigated the expression of distinct HSPs, which are being implicated in
cancer progression, in human tissues of gastric adenocarcinomas. The authors
found that HSP-27, HSP-60, HSP-90 proteins were expressed in gastric
adenocarcinoma specimens. Expression of HSP-27 was significantly associated
with tumor size and the presence of organ metastasis. HSP-90 expression was
not associated with any of the clinicopathological parameters. Surprisingly, high
HSP-90 expression was significantly associated with longer overall survival
times.
Interesting study, especially the fact that Hsp90 expression is associated with an
improved survival is somewhat intriguing. This finding actually demands further
attention, as it could imply that loss of chaperoning (i.e. Hsp90) leads to a more
aggressive phenotype, hence leading to poor prognosis (and resistance to
therapy?). The paper would therefore substantially be improved if authors could
provide data on differences in Hsp90 client protein expression (HER2, EGFR?...)
in these tissues.
Specific comments: Minor Essential Revisions
1. Methods: it is not clear what authors mean with “expression” versus “staining
intensity”, and the relevance of this distinction. Why were two rating systems
applied? I strongly suggest using only one rating system and performing
adequate analysis of relevant variables. In addition, the rationale for the arbitrary
cut-off threshold for Hsp expression (52% vs 48%) is not clear. The authors need
to explain,, or refine this threshold in terms of using one cut-off value throughout
the manuscript (i..e. 50%?).
2. Significant data on “sex” and “age” do not appear to be important variables,
otherwise authors need to explain why this finding is really clinically relevant. I
would suggest omitting these data.
3. What is the clinical significance of Hsp60 expression? This remains unclear. In
addition, Ki-67 staining does not provide any significant information as it does not
correlate with staining. This needs to be addressed or omitted.
4. Tables are very large and contain too many non-relevant data. Authors should
focus and revise. (again using one rating system is sufficient).
5. Figure 1: this figure should be optimized in terms of presenting staining of
normal and tumor tissues of both intestinal and diffuse type cancers, and at two
magnifications (inserts).
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, but I do not feel adequately qualified to assess the
statistics.
Declaration of competing interests:
I declare that I have no competing interests
assistant