PONE-D-24-44914Clinicopathological comparison of eccrine poroma and porocarcinoma: Ki-67 index is not a decisive factorPLOS ONE

Dear Dr. Anna-Stiina Meriläinen,

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Reviewers' comments:

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: The manuscript presents a study comparing clinicopathological factors between eccrine poroma (EP) and porocarcinoma (EPC), with a special focus on the Ki-67 index. The research is well-structured, addresses an important and rather underexplored topic, relevant statistical analysis has been applied.

The abstract provides a good overview but should also emphasize the clinical implications demonstrated by this study. Consider adding future research plans, if any are foreseen.

The introduction is elaborate, scientifically well-supported by the relevant references. I would recommend adding more explanation the hypothesis here why Ki-67 was expected to differ between EP and EPC as it is somewhat elaborated only in the discussion section.

Methods are reasonably described. However, the Ki-67 index analysis could be described even in a bit more detailed manner - for the audience not to be looking into the references 35 and 36. Taking into consideration the rarity of the disease, sample collection and potential biases in the process, sample size calculation / power analysis could also be explained to strengthen the study’s validity.

Results and statistical findings are well-described. Consider discussing the high age in EPC patients as a possible confounding factor and if/how it may have influenced survival presented in Kaplan-Meier curves.

The discussion is interesting to read and reasonably supported by citing other studies. Consider emphasizing the clinical relevance of your findings, e.g., should Ki-67 be used in routine practice to prognose EPC?

Best of luck!

Reviewer #2: The Ki-67 positivity rate in eccrine porocarcinoma (EPC) has been reported. The authors stated that the Ki-67 positivity rate was 0.6% in eccrine poroma (EP) and 0.5% in EPC, indicating no significant difference between the two tumor groups. Although I had expected a slightly higher rate in EPC, the actual rate was not as high.

Whole-exome sequencing identifies distinct genomic aberrations in eccrine porocarcinomas and poromas

To ensure the scientific rigor of the paper, please include the pathological diagnostic criteria for EP and EPC in the Methods section. How about including pathological images of all specimens stained with HE and Ki-67 as supplemental data?

Reviewer #3 : As an academic editor,I would suggest it would be important to discuss these studies in the context of several studies such as the one below that shows distinct genomic aberrations in eccrine porocarcinomas and poromas including TP53 , NCOR1 , and CDKN2A.

                                                                                                                                                                                                                                                                                 Whole-exome sequencing identifies distinct genomic aberrations in eccrine porocarcinomas and poromas.  Puttonen M, Almusa H, Böhling T, Koljonen V, Sihto H. Orphanet J Rare Dis. 2025 Feb 13;20(1):70.

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Reviewer #1: No

Reviewer #2: Yes:  TERUKI YANAGI

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Clinicopathological comparison of eccrine poroma and porocarcinoma: Ki-67 index is not a decisive factor

PONE-D-24-44914R1

Dear Dr. Anna-Stiina Meriläinen

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,

Dr H Boukerche, PhD

Academic Editor

PLOS ONE

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