Tissue and Data Acquisition
Gynecologic oncology patients undergoing surgery at Walter Reed and the University of Pittsburgh Cancer Institute are encouraged to participate in a protocol aimed at collection of tissue normally removed at the time of surgery. In addition, comprehensive epidemiologic data is collected on each participant to include validated questionnaires that are focused on hormone exposure, menstrual history, and racial disparity, in addition to demographic, clinical and pathologic information.
A combination of
self-administered surveys as well as questionnaires administered by trained
interviewers are utilized over the course or the preoperative period and
postoperative recovery to provide over 400 data on each sample. These data are
scanned into database and reviewed for quality assurance before being forwarded
to the Data Ware House at the Windber Research Institute.
This data warehouse (DW) was
built in collaboration with Teradata and Management Sciences Associates (MSA)
and it supports the integration of genomics, proteomics, and clinical parameter
data sets along with public domain data sets. The implementation and deployment
of this data warehouse was achieved in a first phase release in Q4 2003, and
ongoing development focuses on the integration of additional external databases
and interfacing to the Clinical Laboratory Workflow System (CLWS, Amersham) and
the sample repository system (FreezerWorks). The critical element of this data
warehouse is the development of a unique data model that supports both the
complex data integration well beyond simple field pointers and its ongoing
development to incorporate temporal concepts.
In the Gynecologic Disease program, both clinical data collected at the University of Pittsburgh and Walter
Reed Army Medical Center will be transferred to the data warehouse in WRI
monthly increments via secure internet connection by the respective research
staffs. Additional scientific data will also be entered into the DW as it is
collected from investigators at WRI, Walter Reed Army Medical Center and the
University of Pittsburgh. The composite database environment will serve as an
invaluable resource for investigators. WRI is presently planning for Internet II
access to the Data Warehouse by partnered institutions. This will enhance and
facilitate data transfer particularly images for analysis at various sites that
are also planning Internet II access.
The Tissue and Data
Acquisition Activity will be expanded to include additional medical treatment
facilities in the Army and Navy as well as collaborating civilian medical
centers. The program will be a model for inter-institutional cooperation and
research collaboration with comprehensive data on gynecologic cancers. The
Gynecologic Disease Program plans to collaborate with the Gynecologic Oncology
Divisions from Duke University, Ohio State University, and Moffitt Cancer Center
as well as Brooke Army Medical Center, Tripler Army Medical Center and Madigan
Army Medical Center over the course of the next two years.
In addition, the Walter Reed program is
currently collaborating with the United States Military Cancer Institute and the
Armed Forces Institute of Pathology towards the creation of a Tissue Microarray
Facility. The Department of Defense maintains the National Repository for the
Armed Forces Institute of Pathology. This repository contains over three million
cases, the majority of which are rare and obscure pathology specimens, since the
AFIP serves as an expert referee evaluating over 60,000 cases annually.
Tissue
microarrays are being built over the next 12 months to provide large numbers of
paraffin samples of gynecologic disease to facilitate validation of data
generated through other analysis of genes and proteins that appear to be
associated with certain gynecologic disease states.