Title: Evaluating the usefulness of considering the size and morphological type of type B2 vessel
area based on Japan Esophageal Society Classification in estimating tumor invasion depth in
superficial esophageal squamous cell carcinomas: study protocol for a prospective observational
study (Japan BEES study)
Version: 0 Date: 09 Oct 2023
Reviewer's report:
Thank you for inviting me to review the article entitled "Evaluating the usefulness of considering
the size and morphological type of type B2 vessel area based on Japan Esophageal Society
Classification in estimating tumor invasion depth in superficial esophageal squamous cell
carcinomas: study protocol for a prospective observational study (Japan BEES study)". The
authors presented the protocol details, however the trial lacking clinical significance for reasons
as follows:
a.  Even though the accuracy could be improved through this trial, it is  possible that patients
with low risks still require ESD to confirm the diagnosis.  For B2 type vessels, diagnostic ESD
should be recommended and is feasible in most hospitals .
b.  EUS and EUS following endoscopic sub-mucosal  saline injection are more obvious, and
could help to well distinguish most cases suitable for ESD rather than esophagectomy. In
addition, combining use of endoscopic ultrasound  may help increase the diagnostic yield of
this trial.
Title: Evaluating the usefulness of considering the size and morphological type of type B2 vessel
area based on Japan Esophageal Society Classification in estimating tumor invasion depth in
superficial esophageal squamous cell carcinomas: study protocol for a prospective observational
study (Japan BEES study)
Version: 0 Date: 09 Oct 2023
Reviewer's report:
Thank you for inviting me to review the article entitled "Evaluating the usefulness of considering
the size and morphological type of type B2 vessel area based on Japan Esophageal Society
Classification in estimating tumor invasion depth in superficial esophageal squamous cell
carcinomas: study protocol for a prospective observational study (Japan BEES study)". The
authors presented the protocol details, however the trial lacking clinical significance for reasons
as follows:
a.  Even though the accuracy could be improved through this trial, it is  possible that patients
with low risks still require ESD to confirm the diagnosis.  For B2 type vessels, diagnostic ESD
should be recommended and is feasible in most hospitals .
b.  EUS and EUS following endoscopic sub-mucosal  saline injection are more obvious, and
could help to well distinguish most cases suitable for ESD rather than esophagectomy. In
addition, combining use of endoscopic ultrasound  may help increase the diagnostic yield of
this trial.
Please review this paper.
user
Title: Evaluating the usefulness of considering the size and morphological type of type B2 vessel
area based on Japan Esophageal Society Classification in estimating tumor invasion depth in
superficial esophageal squamous cell carcinomas: study protocol for a prospective observational
study (Japan BEES study)
Version: 0 Date: 09 Oct 2023
Reviewer's report:
Thank you for inviting me to review the article entitled "Evaluating the usefulness of considering
the size and morphological type of type B2 vessel area based on Japan Esophageal Society
Classification in estimating tumor invasion depth in superficial esophageal squamous cell
carcinomas: study protocol for a prospective observational study (Japan BEES study)". The
authors presented the protocol details, however the trial lacking clinical significance for reasons
as follows:
a.  Even though the accuracy could be improved through this trial, it is  possible that patients
with low risks still require ESD to confirm the diagnosis.  For B2 type vessels, diagnostic ESD
should be recommended and is feasible in most hospitals .
b.  EUS and EUS following endoscopic sub-mucosal  saline injection are more obvious, and
could help to well distinguish most cases suitable for ESD rather than esophagectomy. In
addition, combining use of endoscopic ultrasound  may help increase the diagnostic yield of
this trial.
assistant