Title: A novel method for early detection of colorectal cancer based on detection of methylation
of two fragments of syndecan-2 (SDC2) in stool DNA
Version: 0 Date: 04 Jan 2022
Reviewer:  Suk-Hwan Lee
Reviewer's report:
The authors employed the syndecan-2(SDC2) methylation assay using stool samples from the
Chinese population to evaluate the feasibility of colorectal cancer(CRC) screening. The authors
also employed the two different SDC2 promoter regions for methylation assay to improve the
sensitivity and specificity of the test.
The strength of the study;
SDC2 is a promising biomarker for colorectal cancer screening now. Like other reports, the
authors successfully established the methylation assay using stool samples as small as 2.5 grams.
The sensitivity of the combined methylation assay improved compared to the single methylation
assay.
The weakness of the study;
Ideally, the screening test needs high sensitivity and specificity. But it isn't easy to achieve the
ideal criteria of the test in reality.
The sensitivity for CRC is 87.28% for combined methylation assay, which is improved
compared to a single methylation assay. However, the differences were not statistically
significant. The sensitivity seemed low compared to the commercially available tests as the
authors described in the manuscript. What do you think is the low sensitivity of the test?
As the differences were not significant, the authors should revise the conclusion.
What number of patients tested the methylation assay in the study? Not 100% of the samples
resulted in the success of the methylation assay. Please describe the technical results of the
methylation assays.
Tables 1, 2, and 5 seemed unnecessary because the authors already described the results in the
manuscript.
Besides the staging of the CRC, do the test results differ based on the location of the tumors?
Besides the advanced adenomas defined by the size and histologic criteria, what are the results
of the detection rates for the smaller adenomas in the study?
Title: A novel method for early detection of colorectal cancer based on detection of methylation
of two fragments of syndecan-2 (SDC2) in stool DNA
Version: 0 Date: 04 Jan 2022
Reviewer:  Suk-Hwan Lee
Reviewer's report:
The authors employed the syndecan-2(SDC2) methylation assay using stool samples from the
Chinese population to evaluate the feasibility of colorectal cancer(CRC) screening. The authors
also employed the two different SDC2 promoter regions for methylation assay to improve the
sensitivity and specificity of the test.
The strength of the study;
SDC2 is a promising biomarker for colorectal cancer screening now. Like other reports, the
authors successfully established the methylation assay using stool samples as small as 2.5 grams.
The sensitivity of the combined methylation assay improved compared to the single methylation
assay.
The weakness of the study;
Ideally, the screening test needs high sensitivity and specificity. But it isn't easy to achieve the
ideal criteria of the test in reality.
The sensitivity for CRC is 87.28% for combined methylation assay, which is improved
compared to a single methylation assay. However, the differences were not statistically
significant. The sensitivity seemed low compared to the commercially available tests as the
authors described in the manuscript. What do you think is the low sensitivity of the test?
As the differences were not significant, the authors should revise the conclusion.
What number of patients tested the methylation assay in the study? Not 100% of the samples
resulted in the success of the methylation assay. Please describe the technical results of the
methylation assays.
Tables 1, 2, and 5 seemed unnecessary because the authors already described the results in the
manuscript.
Besides the staging of the CRC, do the test results differ based on the location of the tumors?
Besides the advanced adenomas defined by the size and histologic criteria, what are the results
of the detection rates for the smaller adenomas in the study?
Please review this paper.
user
Title: A novel method for early detection of colorectal cancer based on detection of methylation
of two fragments of syndecan-2 (SDC2) in stool DNA
Version: 0 Date: 04 Jan 2022
Reviewer:  Suk-Hwan Lee
Reviewer's report:
The authors employed the syndecan-2(SDC2) methylation assay using stool samples from the
Chinese population to evaluate the feasibility of colorectal cancer(CRC) screening. The authors
also employed the two different SDC2 promoter regions for methylation assay to improve the
sensitivity and specificity of the test.
The strength of the study;
SDC2 is a promising biomarker for colorectal cancer screening now. Like other reports, the
authors successfully established the methylation assay using stool samples as small as 2.5 grams.
The sensitivity of the combined methylation assay improved compared to the single methylation
assay.
The weakness of the study;
Ideally, the screening test needs high sensitivity and specificity. But it isn't easy to achieve the
ideal criteria of the test in reality.
The sensitivity for CRC is 87.28% for combined methylation assay, which is improved
compared to a single methylation assay. However, the differences were not statistically
significant. The sensitivity seemed low compared to the commercially available tests as the
authors described in the manuscript. What do you think is the low sensitivity of the test?
As the differences were not significant, the authors should revise the conclusion.
What number of patients tested the methylation assay in the study? Not 100% of the samples
resulted in the success of the methylation assay. Please describe the technical results of the
methylation assays.
Tables 1, 2, and 5 seemed unnecessary because the authors already described the results in the
manuscript.
Besides the staging of the CRC, do the test results differ based on the location of the tumors?
Besides the advanced adenomas defined by the size and histologic criteria, what are the results
of the detection rates for the smaller adenomas in the study?
assistant