Reviewer’ s report
Title: Endoscopic severe mucosal atrophy indicates the presence of gastric cancer after
Helicobacter pylori eradication -Analysis based on the Kyoto classification
Version: 1Date: 24 May 2020
Reviewer's report:
1.In the post HP eradication era, more and more gastric cancer develope after HP eradication,
which account at least 25% of cases. Previous studies all focus on the risk factors on the predictionor relation of HP positive Gastric cancer. So it is important to pay more attention on study on thePost HP eradicated cases. To my limited knowledge, this study is the first one which only focus onthe Gastric cancer post HP eradication. So it is useful and meaningful in clinically practice.2. Intestinal metaplasia and atrophy are thought to be predictor for the development of gastric earlycancer in HP+ patients. But post HP eradicated, the mucosal background will change and it isunsure that these 2 predictors (IM/atrophy) would still have the predict power. I think this studycan bring us some evidence on it .3.Here are some questions to be considered :
1.We are glad to see the positive result of atrophy / diffuse redness/ map like redness in the
univariate analysis , but after put them into secondary multiple variate analysis, we don't find thedata of map like redness. Is it absence of statistic power or other reason ?
2.Since the conclusion is that atrophy can predict the post HP Gastric cancer, we want to know
more in the research. But we found the Statistic power in logistic regression model is not enough(P>0.997, OR 1013681190). OR is too large and I think it is need to require statistic expert toreview or can explain more in the discussion.
3.In the evaluation part , it was mentioned that 163 patients were studied for the calculation for
the probability. We want to know the origin and structure of 163 patients.
4.Since the primary independence variable is category data (not continuous data) , I am not sure
is it suitable to use youden index to test the threshold . If have to do so, we want to know theyounden index value also ,not only the threshold 0.1892. Because is also can represent the ROCdiagnostic power. By the way I recommend to have statistic expert to review once.4.There is a typo on supplement table -2 , subject -> subject
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which 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.
YesAre 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 furtherassessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, 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 interestsReviewer Publication Consent. 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) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not be published.If
you are not happy for us to publish this report, please contact the editorial office before completing
the review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.
(default)
Reviewer’ s report
Title: Endoscopic severe mucosal atrophy indicates the presence of gastric cancer after
Helicobacter pylori eradication -Analysis based on the Kyoto classification
Version: 1Date: 24 May 2020
Reviewer's report:
1.In the post HP eradication era, more and more gastric cancer develope after HP eradication,
which account at least 25% of cases. Previous studies all focus on the risk factors on the predictionor relation of HP positive Gastric cancer. So it is important to pay more attention on study on thePost HP eradicated cases. To my limited knowledge, this study is the first one which only focus onthe Gastric cancer post HP eradication. So it is useful and meaningful in clinically practice.2. Intestinal metaplasia and atrophy are thought to be predictor for the development of gastric earlycancer in HP+ patients. But post HP eradicated, the mucosal background will change and it isunsure that these 2 predictors (IM/atrophy) would still have the predict power. I think this studycan bring us some evidence on it .3.Here are some questions to be considered :
1.We are glad to see the positive result of atrophy / diffuse redness/ map like redness in the
univariate analysis , but after put them into secondary multiple variate analysis, we don't find thedata of map like redness. Is it absence of statistic power or other reason ?
2.Since the conclusion is that atrophy can predict the post HP Gastric cancer, we want to know
more in the research. But we found the Statistic power in logistic regression model is not enough(P>0.997, OR 1013681190). OR is too large and I think it is need to require statistic expert toreview or can explain more in the discussion.
3.In the evaluation part , it was mentioned that 163 patients were studied for the calculation for
the probability. We want to know the origin and structure of 163 patients.
4.Since the primary independence variable is category data (not continuous data) , I am not sure
is it suitable to use youden index to test the threshold . If have to do so, we want to know theyounden index value also ,not only the threshold 0.1892. Because is also can represent the ROCdiagnostic power. By the way I recommend to have statistic expert to review once.4.There is a typo on supplement table -2 , subject -> subject
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which 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.
YesAre 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 furtherassessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, 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 interestsReviewer Publication Consent. 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) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not be published.If
you are not happy for us to publish this report, please contact the editorial office before completing
the review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.
(default)
Please review this paper.
user
Reviewer’ s report
Title: Endoscopic severe mucosal atrophy indicates the presence of gastric cancer after
Helicobacter pylori eradication -Analysis based on the Kyoto classification
Version: 1Date: 24 May 2020
Reviewer's report:
1.In the post HP eradication era, more and more gastric cancer develope after HP eradication,
which account at least 25% of cases. Previous studies all focus on the risk factors on the predictionor relation of HP positive Gastric cancer. So it is important to pay more attention on study on thePost HP eradicated cases. To my limited knowledge, this study is the first one which only focus onthe Gastric cancer post HP eradication. So it is useful and meaningful in clinically practice.2. Intestinal metaplasia and atrophy are thought to be predictor for the development of gastric earlycancer in HP+ patients. But post HP eradicated, the mucosal background will change and it isunsure that these 2 predictors (IM/atrophy) would still have the predict power. I think this studycan bring us some evidence on it .3.Here are some questions to be considered :
1.We are glad to see the positive result of atrophy / diffuse redness/ map like redness in the
univariate analysis , but after put them into secondary multiple variate analysis, we don't find thedata of map like redness. Is it absence of statistic power or other reason ?
2.Since the conclusion is that atrophy can predict the post HP Gastric cancer, we want to know
more in the research. But we found the Statistic power in logistic regression model is not enough(P>0.997, OR 1013681190). OR is too large and I think it is need to require statistic expert toreview or can explain more in the discussion.
3.In the evaluation part , it was mentioned that 163 patients were studied for the calculation for
the probability. We want to know the origin and structure of 163 patients.
4.Since the primary independence variable is category data (not continuous data) , I am not sure
is it suitable to use youden index to test the threshold . If have to do so, we want to know theyounden index value also ,not only the threshold 0.1892. Because is also can represent the ROCdiagnostic power. By the way I recommend to have statistic expert to review once.4.There is a typo on supplement table -2 , subject -> subject
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which 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.
YesAre 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 furtherassessment in your comments to the editors.
I recommend additional statistical review
Quality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, 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 interestsReviewer Publication Consent. 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) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the published
report have been included as confidential comments to the editor, which will not be published.If
you are not happy for us to publish this report, please contact the editorial office before completing
the review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.
(default)
assistant