Reviewer ’s report  
 
Title: Clinical and Genomic characteristics of mucosal signet -ring cell carcinoma in   
Helicobacter  pylori -uninfected stomach  
 
Version: 0 Date: 04 Jun 2020  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report wh ich cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
 
Dear author,  
In general It was a pleasure for me to review your well documented, structured manuscript.  I 
have only one point to note.  
Related t o Absract section: page 4, line 54:  
'Smoking is not a main carcinogenic factor for the development of SRCCs.'  
That conclusion statement seems to be very straight forward and beyond the scope of the study. 
As you indicated in Discussion section, page 17, lines 227 to 233; 'Notably, it should be 
emphasized that the prevalence of smokers was higher among the H. pylori -uninfected patients 
with SRCCs than among the H. pylori -infected patients. This finding is compatible with the 
previous report by Horiuchi et al. However, in our study concerning the genetic alterations in 
SRCC tissue samples, we could not find any C to A mutations, which are recognized as 
smoking -induced alterations, despite including samples from some heavy smokers in our 
analysis. Smoking may  be a confounding factor as to the pathogenesis of SRCCs without H. 
pylori infection.' So as you stated, smoking may be a confounding factor.  
If you softened that conclusion to 'Smoking may not be the main carcinogenic factor for the 
development of SRCCs a mong the H. pylori -uninfected patients' then it will be acceptable.  
Thank you  
 
 
Are the methods appropriate and well described?  
If not, pl ease specify what is required in your comments to the authors.  
 
Yes 
 
Does 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 da ta shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are 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 as pects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration 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 publi cation of this  
manuscript, 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 curr ently 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 interests  
 
Reviewer 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 
manuscript  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 must  decide whether to include your name at the start of the process and confirm 
this decision whenever  prompted. 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: Clinical and Genomic characteristics of mucosal signet -ring cell carcinoma in   
Helicobacter  pylori -uninfected stomach  
 
Version: 0 Date: 04 Jun 2020  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report wh ich cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
 
Dear author,  
In general It was a pleasure for me to review your well documented, structured manuscript.  I 
have only one point to note.  
Related t o Absract section: page 4, line 54:  
'Smoking is not a main carcinogenic factor for the development of SRCCs.'  
That conclusion statement seems to be very straight forward and beyond the scope of the study. 
As you indicated in Discussion section, page 17, lines 227 to 233; 'Notably, it should be 
emphasized that the prevalence of smokers was higher among the H. pylori -uninfected patients 
with SRCCs than among the H. pylori -infected patients. This finding is compatible with the 
previous report by Horiuchi et al. However, in our study concerning the genetic alterations in 
SRCC tissue samples, we could not find any C to A mutations, which are recognized as 
smoking -induced alterations, despite including samples from some heavy smokers in our 
analysis. Smoking may  be a confounding factor as to the pathogenesis of SRCCs without H. 
pylori infection.' So as you stated, smoking may be a confounding factor.  
If you softened that conclusion to 'Smoking may not be the main carcinogenic factor for the 
development of SRCCs a mong the H. pylori -uninfected patients' then it will be acceptable.  
Thank you  
 
 
Are the methods appropriate and well described?  
If not, pl ease specify what is required in your comments to the authors.  
 
Yes 
 
Does 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 da ta shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are 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 as pects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration 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 publi cation of this  
manuscript, 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 curr ently 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 interests  
 
Reviewer 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 
manuscript  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 must  decide whether to include your name at the start of the process and confirm 
this decision whenever  prompted. 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: Clinical and Genomic characteristics of mucosal signet -ring cell carcinoma in   
Helicobacter  pylori -uninfected stomach  
 
Version: 0 Date: 04 Jun 2020  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only upload as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report wh ich cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
 
Dear author,  
In general It was a pleasure for me to review your well documented, structured manuscript.  I 
have only one point to note.  
Related t o Absract section: page 4, line 54:  
'Smoking is not a main carcinogenic factor for the development of SRCCs.'  
That conclusion statement seems to be very straight forward and beyond the scope of the study. 
As you indicated in Discussion section, page 17, lines 227 to 233; 'Notably, it should be 
emphasized that the prevalence of smokers was higher among the H. pylori -uninfected patients 
with SRCCs than among the H. pylori -infected patients. This finding is compatible with the 
previous report by Horiuchi et al. However, in our study concerning the genetic alterations in 
SRCC tissue samples, we could not find any C to A mutations, which are recognized as 
smoking -induced alterations, despite including samples from some heavy smokers in our 
analysis. Smoking may  be a confounding factor as to the pathogenesis of SRCCs without H. 
pylori infection.' So as you stated, smoking may be a confounding factor.  
If you softened that conclusion to 'Smoking may not be the main carcinogenic factor for the 
development of SRCCs a mong the H. pylori -uninfected patients' then it will be acceptable.  
Thank you  
 
 
Are the methods appropriate and well described?  
If not, pl ease specify what is required in your comments to the authors.  
 
Yes 
 
Does 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 da ta shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are 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 as pects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration 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 publi cation of this  
manuscript, 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 curr ently 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 interests  
 
Reviewer 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 
manuscript  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 must  decide whether to include your name at the start of the process and confirm 
this decision whenever  prompted. 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