Reviewer ’s report  
 
Title: Highest power magnification with narrow -band imaging is useful for improving diagnostic  
performance for endoscopic delineation of early gastric cancers.  
 
Version: 0 Date: 23 Aug 2015  
 
Reviewer: Ming -Jen Chen  
 
Reviewer's report:  
 
Commen ts to the authors:  
 
1. The concept of this manuscript is quite interesting. As we know gold  standard is used to 
refer to the most accurate test possible without restrictions. The authors  described in the 
method section, the biopsy was taken only when the dema rcation line could not be  
delineated in its entirety even using HM -NBI. We wander there is not a unique "golden 
standard to  confirm the diagnostic accuracy for evaluation CM, CE+LM -NBI and 
CE+LM -NBI+HM -NBI.  
 
2. Magnifying endoscopic examination at the higher  power magnification provides the 
better  spatial resolution, thus the novelty of this retrospective study is limited.  
 
3. In the method session,  the authors performed ESD procedure using HM -NBI to identify 
the lesion margin, and made  markings 3 -5 mm outside the DL and then histological 
examination confirms the presence of  cancer within the markings. The cutting margin on 
the markings is 3 -5 mm outside the DL, how  did you confirm the presence of cancerous 
cell on the DL from the cutting margin?  
 
4. Examinations  using the highest power magnification level are technically difficult and 
time consumption. In this  study, the application of highest power magnification is 
especially on the 0 -IIb lesion with only  significant than CE+LM -NBI. Will you suggest 
only applicati on of HM -NBI in this situation that  is more cost effective?  
 
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 whi ch 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.  
 
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 in dicate 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 f ive 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 jour nal. 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: Highest power magnification with narrow -band imaging is useful for improving diagnostic  
performance for endoscopic delineation of early gastric cancers.  
 
Version: 0 Date: 23 Aug 2015  
 
Reviewer: Ming -Jen Chen  
 
Reviewer's report:  
 
Commen ts to the authors:  
 
1. The concept of this manuscript is quite interesting. As we know gold  standard is used to 
refer to the most accurate test possible without restrictions. The authors  described in the 
method section, the biopsy was taken only when the dema rcation line could not be  
delineated in its entirety even using HM -NBI. We wander there is not a unique "golden 
standard to  confirm the diagnostic accuracy for evaluation CM, CE+LM -NBI and 
CE+LM -NBI+HM -NBI.  
 
2. Magnifying endoscopic examination at the higher  power magnification provides the 
better  spatial resolution, thus the novelty of this retrospective study is limited.  
 
3. In the method session,  the authors performed ESD procedure using HM -NBI to identify 
the lesion margin, and made  markings 3 -5 mm outside the DL and then histological 
examination confirms the presence of  cancer within the markings. The cutting margin on 
the markings is 3 -5 mm outside the DL, how  did you confirm the presence of cancerous 
cell on the DL from the cutting margin?  
 
4. Examinations  using the highest power magnification level are technically difficult and 
time consumption. In this  study, the application of highest power magnification is 
especially on the 0 -IIb lesion with only  significant than CE+LM -NBI. Will you suggest 
only applicati on of HM -NBI in this situation that  is more cost effective?  
 
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 whi ch 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.  
 
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 in dicate 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 f ive 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 jour nal. 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: Highest power magnification with narrow -band imaging is useful for improving diagnostic  
performance for endoscopic delineation of early gastric cancers.  
 
Version: 0 Date: 23 Aug 2015  
 
Reviewer: Ming -Jen Chen  
 
Reviewer's report:  
 
Commen ts to the authors:  
 
1. The concept of this manuscript is quite interesting. As we know gold  standard is used to 
refer to the most accurate test possible without restrictions. The authors  described in the 
method section, the biopsy was taken only when the dema rcation line could not be  
delineated in its entirety even using HM -NBI. We wander there is not a unique "golden 
standard to  confirm the diagnostic accuracy for evaluation CM, CE+LM -NBI and 
CE+LM -NBI+HM -NBI.  
 
2. Magnifying endoscopic examination at the higher  power magnification provides the 
better  spatial resolution, thus the novelty of this retrospective study is limited.  
 
3. In the method session,  the authors performed ESD procedure using HM -NBI to identify 
the lesion margin, and made  markings 3 -5 mm outside the DL and then histological 
examination confirms the presence of  cancer within the markings. The cutting margin on 
the markings is 3 -5 mm outside the DL, how  did you confirm the presence of cancerous 
cell on the DL from the cutting margin?  
 
4. Examinations  using the highest power magnification level are technically difficult and 
time consumption. In this  study, the application of highest power magnification is 
especially on the 0 -IIb lesion with only  significant than CE+LM -NBI. Will you suggest 
only applicati on of HM -NBI in this situation that  is more cost effective?  
 
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 whi ch 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.  
 
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 in dicate 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 f ive 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 jour nal. 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