Reviewer's report
Title:A novel biomarker TERTmRNA is applicable for an early detection of
hepatoma
Version: 1Date:7 September 2009
Reviewer: helen Reeves
Reviewer's report:
This is an interesting and thorough research study, which includes large numbers
of patients and appropriate controls. It is generally well written and represents an
important contribution to the serach for diagnostic biomarkers for early HCC in
patients with chronic viral hepatitis.
Major Compulsory Revisions / Minor Essential Revisions :
The authors demonstrate very clearly that serum hTERT mRNA is superior as a
biomarker, both in terms of sensitivity and specificity , and positive and negative
predictive values, to other commonly used biomarkers. However, although the
authors comment, for example, on the numbers of patients negative for one
biomarker who were positive for another, they do not present data analysing the
success of combinations of biomarkers. eg. what is the level of improvement in
sensitivity and specificity when combining hTERT with AFP ? or with DCP ? This
would be particularly interesting for the early/smaller tumours. Really, I would
have liked to see more of the data for different size and differentiation grade
tumours. Figure 5 is excellent in this regard for size, and a similar figure for grade
may further enhance the manuscript, but do not reveal additional value of
biomarker combinations.
Discretionary revisions - The authors imply in their abstract, introduction and
early discussion that it is primarily because HCC is a complex disease, involving
many cellular signalling pathways, that a novel biomarker is required. While this
may well be true, it is primarily because the presently used biomarkers are not
sufficiently good enough, especially in early disease, to be used as surveillance
or diagnostic tests. I would suggest this be introduced at an earlier stage.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Reviewer's report
Title:A novel biomarker TERTmRNA is applicable for an early detection of
hepatoma
Version: 1Date:7 September 2009
Reviewer: helen Reeves
Reviewer's report:
This is an interesting and thorough research study, which includes large numbers
of patients and appropriate controls. It is generally well written and represents an
important contribution to the serach for diagnostic biomarkers for early HCC in
patients with chronic viral hepatitis.
Major Compulsory Revisions / Minor Essential Revisions :
The authors demonstrate very clearly that serum hTERT mRNA is superior as a
biomarker, both in terms of sensitivity and specificity , and positive and negative
predictive values, to other commonly used biomarkers. However, although the
authors comment, for example, on the numbers of patients negative for one
biomarker who were positive for another, they do not present data analysing the
success of combinations of biomarkers. eg. what is the level of improvement in
sensitivity and specificity when combining hTERT with AFP ? or with DCP ? This
would be particularly interesting for the early/smaller tumours. Really, I would
have liked to see more of the data for different size and differentiation grade
tumours. Figure 5 is excellent in this regard for size, and a similar figure for grade
may further enhance the manuscript, but do not reveal additional value of
biomarker combinations.
Discretionary revisions - The authors imply in their abstract, introduction and
early discussion that it is primarily because HCC is a complex disease, involving
many cellular signalling pathways, that a novel biomarker is required. While this
may well be true, it is primarily because the presently used biomarkers are not
sufficiently good enough, especially in early disease, to be used as surveillance
or diagnostic tests. I would suggest this be introduced at an earlier stage.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
Please review this paper.
user
Reviewer's report
Title:A novel biomarker TERTmRNA is applicable for an early detection of
hepatoma
Version: 1Date:7 September 2009
Reviewer: helen Reeves
Reviewer's report:
This is an interesting and thorough research study, which includes large numbers
of patients and appropriate controls. It is generally well written and represents an
important contribution to the serach for diagnostic biomarkers for early HCC in
patients with chronic viral hepatitis.
Major Compulsory Revisions / Minor Essential Revisions :
The authors demonstrate very clearly that serum hTERT mRNA is superior as a
biomarker, both in terms of sensitivity and specificity , and positive and negative
predictive values, to other commonly used biomarkers. However, although the
authors comment, for example, on the numbers of patients negative for one
biomarker who were positive for another, they do not present data analysing the
success of combinations of biomarkers. eg. what is the level of improvement in
sensitivity and specificity when combining hTERT with AFP ? or with DCP ? This
would be particularly interesting for the early/smaller tumours. Really, I would
have liked to see more of the data for different size and differentiation grade
tumours. Figure 5 is excellent in this regard for size, and a similar figure for grade
may further enhance the manuscript, but do not reveal additional value of
biomarker combinations.
Discretionary revisions - The authors imply in their abstract, introduction and
early discussion that it is primarily because HCC is a complex disease, involving
many cellular signalling pathways, that a novel biomarker is required. While this
may well be true, it is primarily because the presently used biomarkers are not
sufficiently good enough, especially in early disease, to be used as surveillance
or diagnostic tests. I would suggest this be introduced at an earlier stage.
Level of interest: An article of importance in its field
Quality of written English: Acceptable
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests
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