Reviewer's report
Title:Morphological change of a laterally spreading rectal tumor over a short
period
Version: 1Date:3 January 2013
Reviewer: Cord Langner
Reviewer's report:
The case report by Miyamoto and eight (!) co-workers reports on the evolution of
a LST over a period of three months. The manuscript includes very nice images,
but the significance of the report is unclear.
Major Compulsory Revisions
For a “Western” gastrointestinal pathologist this is a clear cut tubular adenoma,
low grade dysplasia (intraepithelial neoplasia) according to WHO, both in the flat
parts (please do not say “very flat”, flat is flat) and in the elevated parts. Tumors
are heterogeneous. Thus, no wonder that some parts appear "more normal" (the
flat parts) than others. But, in 2000, the WHO made, for good reasons, i.e. to
reduce interobserver variation, all this low grade dysplasia (intraepithelial
neoplasia). If you want to publish outside Japan, please be so kind and adhere
adhere to this terminology.
It is important to realize, that there is not evidence of SSA, neither
macroscopically nor (more important) microscopically, this is a simple low grade
tubular adenoma. It can, therefore, not be recommended to move the discussion
into the direction of SSA and non-Lynch MSI sporadic colorectal cancer. Your
lesion is for sure not evolving into this type of malignancy.
In addition, if (for a case report) molecular analysis is needed (I guess you would
like to go for KRAS, BRAF and MSI) you should go for it and submit the
manuscript having done this analysis – this analysis takes at maximum two days!
Most probably, however, the lesion will be negative for BRAF mutation,
microsatellite stabile and regarding KRAS both options (mutated or wild type) are
possible. But does that really help us?
Thus, we have a LST, which on histology proved to be a low grade tubular
adenoma, which is seen twice within three months (we have endoscopy with NBI
twice, histology only from the resection) and which shows some changes in
shape (not in size) and in pit pattern, which upon histology are largely irrelevant.
Thus, what is the message? If a LST shows some changes in shape and pit
pattern, do not worry? Please explain.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Reviewer's report
Title:Morphological change of a laterally spreading rectal tumor over a short
period
Version: 1Date:3 January 2013
Reviewer: Cord Langner
Reviewer's report:
The case report by Miyamoto and eight (!) co-workers reports on the evolution of
a LST over a period of three months. The manuscript includes very nice images,
but the significance of the report is unclear.
Major Compulsory Revisions
For a “Western” gastrointestinal pathologist this is a clear cut tubular adenoma,
low grade dysplasia (intraepithelial neoplasia) according to WHO, both in the flat
parts (please do not say “very flat”, flat is flat) and in the elevated parts. Tumors
are heterogeneous. Thus, no wonder that some parts appear "more normal" (the
flat parts) than others. But, in 2000, the WHO made, for good reasons, i.e. to
reduce interobserver variation, all this low grade dysplasia (intraepithelial
neoplasia). If you want to publish outside Japan, please be so kind and adhere
adhere to this terminology.
It is important to realize, that there is not evidence of SSA, neither
macroscopically nor (more important) microscopically, this is a simple low grade
tubular adenoma. It can, therefore, not be recommended to move the discussion
into the direction of SSA and non-Lynch MSI sporadic colorectal cancer. Your
lesion is for sure not evolving into this type of malignancy.
In addition, if (for a case report) molecular analysis is needed (I guess you would
like to go for KRAS, BRAF and MSI) you should go for it and submit the
manuscript having done this analysis – this analysis takes at maximum two days!
Most probably, however, the lesion will be negative for BRAF mutation,
microsatellite stabile and regarding KRAS both options (mutated or wild type) are
possible. But does that really help us?
Thus, we have a LST, which on histology proved to be a low grade tubular
adenoma, which is seen twice within three months (we have endoscopy with NBI
twice, histology only from the resection) and which shows some changes in
shape (not in size) and in pit pattern, which upon histology are largely irrelevant.
Thus, what is the message? If a LST shows some changes in shape and pit
pattern, do not worry? Please explain.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Please review this paper.
user
Reviewer's report
Title:Morphological change of a laterally spreading rectal tumor over a short
period
Version: 1Date:3 January 2013
Reviewer: Cord Langner
Reviewer's report:
The case report by Miyamoto and eight (!) co-workers reports on the evolution of
a LST over a period of three months. The manuscript includes very nice images,
but the significance of the report is unclear.
Major Compulsory Revisions
For a “Western” gastrointestinal pathologist this is a clear cut tubular adenoma,
low grade dysplasia (intraepithelial neoplasia) according to WHO, both in the flat
parts (please do not say “very flat”, flat is flat) and in the elevated parts. Tumors
are heterogeneous. Thus, no wonder that some parts appear "more normal" (the
flat parts) than others. But, in 2000, the WHO made, for good reasons, i.e. to
reduce interobserver variation, all this low grade dysplasia (intraepithelial
neoplasia). If you want to publish outside Japan, please be so kind and adhere
adhere to this terminology.
It is important to realize, that there is not evidence of SSA, neither
macroscopically nor (more important) microscopically, this is a simple low grade
tubular adenoma. It can, therefore, not be recommended to move the discussion
into the direction of SSA and non-Lynch MSI sporadic colorectal cancer. Your
lesion is for sure not evolving into this type of malignancy.
In addition, if (for a case report) molecular analysis is needed (I guess you would
like to go for KRAS, BRAF and MSI) you should go for it and submit the
manuscript having done this analysis – this analysis takes at maximum two days!
Most probably, however, the lesion will be negative for BRAF mutation,
microsatellite stabile and regarding KRAS both options (mutated or wild type) are
possible. But does that really help us?
Thus, we have a LST, which on histology proved to be a low grade tubular
adenoma, which is seen twice within three months (we have endoscopy with NBI
twice, histology only from the resection) and which shows some changes in
shape (not in size) and in pit pattern, which upon histology are largely irrelevant.
Thus, what is the message? If a LST shows some changes in shape and pit
pattern, do not worry? Please explain.
Level of interest: An article of limited interest
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
assistant