PONE-D-23-37967High-throughput viable circulating tumor cell isolation using tapered-slit membrane filter-based chipsets in the differential diagnosis of ovarian tumorsPLOS ONE

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: Merits

1. 81 (40.3%) benign tumors, 31 (15.4%) borderline tumors, and 89 (44.3%) ovarian cancers were pathologically confirmed.

2. Eighty-one (40.3%), 31 (15.4%), and 89 (44.3%) were pathologically confirmed with benign, borderline, and malignant tumors, respectively.

3. The frequency of age > 48 years (60.7% vs 34.6%, p=0.001) and the frequency of tumor size > 11cm (46.1% vs 24.7%, p=0.004) were significantly higher in the malignant group compared to the benign group.

4. The frequency of abnormal CA-125 was significantly higher in the malignant group compared to the benign and borderline groups.

5. There were significant differences in the frequencies of age > 48 years, tumor size > 171 11 cm, and malignant diagnoses on CT/MRI

Limitations of the study.

1. Blood samples were collected prospectively for the purpose of CTC detection, while clinical data was gathered retrospectively through a thorough review of medical records.

2. some of the biomarkers like circulating tumor DNA ctDNA, Exosomes, EPCAM, MUC1, CEA and HE4 were not analyzed in this study.

3. It should be noted that due to the subjective nature of interpreting ultrasound findings, there may be variations in RMI results among clinicians.

4. Line no 103 - planned (spelling mistake)

Reviewer #2: The present article " High-throughput viable circulating tumor cell isolation using tapered-slit membrane filter-based chipsets in the differential diagnosis of ovarian tumors” by Kim et al provides information regarding isolation of circulating tumor cells (CTCs) using tapered-slit membrane filter (TSF)-based chipsets for the differential diagnosis of adnexal tumor in comparison with other diagnostic method. The study showed that the sensitivity, specificity, and accuracy of CTC alone using the TSF platform were comparable to those of CA-125 alone in differentiating ovarian cancer from benign tumor. The diagnostic performance of CTC alone or CA-125 alone was lower than that of CT/MRI however this could be overcome by combining CTC and CA-125 for improving the diagnostic accuracy of ovarian cancer. Overall, these are the novel observations, and the data support the main conclusion. The overall language in the main text is clear except few minor grammatical errors (Line 103 - Planed surgery). The experimental design was appropriate. The research question was well-defined. Experimental methods were described with sufficient detail. The figures and tables are displayed nicely, and the results supports the conclusion.

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Reviewer #1: No

Reviewer #2: No

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High-throughput viable circulating tumor cell isolation using tapered-slit membrane filter-based chipsets in the differential diagnosis of ovarian tumors

PONE-D-23-37967R1

Dear Dr. Kim,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Girijesh Kumar Patel, PhD

Academic Editor

PLOS ONE

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