Title: Coexistence of early gastric cancer and benign submucosal lesions mimic invasive cancer:
a retrospective multicenter experience
Version: 2 Date: 20 Oct 2023
Reviewer's report:
I read the article with interest. I think the concept here is familiar for most of endoscopists in
their clinical practice. As described here, EGC with SMT is not frequent as only 3.5% of all their
cases and 67% of them was gastritis cystica profunda. I raise some comments including major.
Major
1. Diagnostic accuracy was compared between EGC with SMT and “simple EGC”. There is no
concrete description of the latter group. I don’t understand what simple EGC is. How many cases
were compared? What kind of lesions? This is fairly critical issue if you compare diagnostic
accuracies.
2. EUS was performed in only 10 cases and only 6 revealed the submucosal entity. Given the
data in table 3, only 30.77% (4/13) has been made definitive diagnosis by EUS, why authors
could conclude “early cardiac-differentiated cancer with gastritis cystica profunda is the most
common condition, and EUS is a useful modality” in their abstract and in the conclusion.
3. There are no detail results on over- or under- diagnosis in the analysis with different levels
of endoscopists.
4. In discussion, findings in EUS are discussed. However, it is narrative and not oriented with
the present result. Five characteristics were discussed but they are not appeared in the result.
Please discuss what you found in the study.
5. I’m not convinced with figure 2, case15. It seems to be not sufficiently inflated in observation
with white light imaging. Please consider other imaging or other cases.
Minor
No information is provided what the number in side means in figure 6.
Title: Coexistence of early gastric cancer and benign submucosal lesions mimic invasive cancer:
a retrospective multicenter experience
Version: 2 Date: 20 Oct 2023
Reviewer's report:
I read the article with interest. I think the concept here is familiar for most of endoscopists in
their clinical practice. As described here, EGC with SMT is not frequent as only 3.5% of all their
cases and 67% of them was gastritis cystica profunda. I raise some comments including major.
Major
1. Diagnostic accuracy was compared between EGC with SMT and “simple EGC”. There is no
concrete description of the latter group. I don’t understand what simple EGC is. How many cases
were compared? What kind of lesions? This is fairly critical issue if you compare diagnostic
accuracies.
2. EUS was performed in only 10 cases and only 6 revealed the submucosal entity. Given the
data in table 3, only 30.77% (4/13) has been made definitive diagnosis by EUS, why authors
could conclude “early cardiac-differentiated cancer with gastritis cystica profunda is the most
common condition, and EUS is a useful modality” in their abstract and in the conclusion.
3. There are no detail results on over- or under- diagnosis in the analysis with different levels
of endoscopists.
4. In discussion, findings in EUS are discussed. However, it is narrative and not oriented with
the present result. Five characteristics were discussed but they are not appeared in the result.
Please discuss what you found in the study.
5. I’m not convinced with figure 2, case15. It seems to be not sufficiently inflated in observation
with white light imaging. Please consider other imaging or other cases.
Minor
No information is provided what the number in side means in figure 6.
Please review this paper.
user
Title: Coexistence of early gastric cancer and benign submucosal lesions mimic invasive cancer:
a retrospective multicenter experience
Version: 2 Date: 20 Oct 2023
Reviewer's report:
I read the article with interest. I think the concept here is familiar for most of endoscopists in
their clinical practice. As described here, EGC with SMT is not frequent as only 3.5% of all their
cases and 67% of them was gastritis cystica profunda. I raise some comments including major.
Major
1. Diagnostic accuracy was compared between EGC with SMT and “simple EGC”. There is no
concrete description of the latter group. I don’t understand what simple EGC is. How many cases
were compared? What kind of lesions? This is fairly critical issue if you compare diagnostic
accuracies.
2. EUS was performed in only 10 cases and only 6 revealed the submucosal entity. Given the
data in table 3, only 30.77% (4/13) has been made definitive diagnosis by EUS, why authors
could conclude “early cardiac-differentiated cancer with gastritis cystica profunda is the most
common condition, and EUS is a useful modality” in their abstract and in the conclusion.
3. There are no detail results on over- or under- diagnosis in the analysis with different levels
of endoscopists.
4. In discussion, findings in EUS are discussed. However, it is narrative and not oriented with
the present result. Five characteristics were discussed but they are not appeared in the result.
Please discuss what you found in the study.
5. I’m not convinced with figure 2, case15. It seems to be not sufficiently inflated in observation
with white light imaging. Please consider other imaging or other cases.
Minor
No information is provided what the number in side means in figure 6.
assistant