ID

10797

Description

North Central Cancer Treatment Group - Pathology Specimen Submission Form NCT00490139 ALTTO (Adjuvant Lapatinib And/Or Trastuzumab Treatment Optimisation) Study; BIG 2-06/N063D Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=30AE3367-6DB2-0D0A-E044-0003BA3F9857

Lien

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=30AE3367-6DB2-0D0A-E044-0003BA3F9857

Mots-clés

Versions (3)
  1. 20/09/2012 20/09/2012 -
  2. 08/01/2015 08/01/2015 - Martin Dugas
  3. 08/06/2015 08/06/2015 -
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8 juin 2015

DOI

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Licence

Creative Commons BY-NC 3.0 Legacy
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North Central Cancer Treatment Group - Pathology Specimen Submission Form NCT00490139

Anglais

No Instruction available.

1 Formulaires  
  1. StudyEvent: North Central Cancer Treatment Group - Pathology Specimen Submission Form
    1. No Instruction available.
Header Module
Description

Header Module

NCCTG Study No.
Description

Protocol ID NCCTG

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C3274381
NCI Thesaurus ObjectClass
C25320
UMLS CUI-2
C1518419
NCI Thesaurus Property
C25364
NCI Thesaurus Property-2
C25581
Central Pathology ID Number
Description

PathologyCoreFacilityLaboratoryIdentifierNumber

Type de données

text

Alias
NCI Thesaurus ObjectClass
C37984
UMLS 2011AA ObjectClass
C0022877
NCI Thesaurus ObjectClass-2
C18189
UMLS 2011AA ObjectClass-2
C0030664
NCI Thesaurus ObjectClass-3
C15896
UMLS 2011AA ObjectClass-3
C1511521
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
Patient Initials
Description

Patient Initials

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C2986440
NCI Thesaurus ObjectClass
C16960
NCI Thesaurus Property
C25536
Institution Number
Description

Institution Number

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
UMLS CUI-2
C0805701
NCI Thesaurus Property
C25364
Institution
Description

Institution Name

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS CUI-1
C1301943
NCI Thesaurus ObjectClass
C21541
NCI Thesaurus ValueDomain-2
C21541
NCI Thesaurus Property
C25364
Biopsy specimen / Lab
Description

Biopsy specimen / Lab

Date Specimen Shipped
Description

SpecimenLabSubmittedDate

Type de données

date

Alias
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus Property
C25294
UMLS 2011AA Property
C0022885
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property-2
C25695
UMLS 2011AA Property-2
C1515023
Number of blocks sent
Description

SpecimenBlockSubmissionCount

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
NCI Thesaurus Property
C25436
UMLS 2011AA Property
C1533157
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property-2
C25694
UMLS 2011AA Property-2
C1515022
ER Status (Local ER/PrG Result)
Description

ERLevelTumorStatus

Type de données

text

Alias
NCI Thesaurus ValueDomain
C3262
UMLS 2011AA ValueDomain
C0027651
NCI Thesaurus ObjectClass
C17069
UMLS 2011AA ObjectClass
C0034804
NCI Thesaurus ValueDomain-2
C25688
UMLS 2011AA ValueDomain-2
C0449438
NCI Thesaurus Property
C25554
UMLS 2011AA Property
C0441889
ER % cells stained positive
Description

LaboratoryProcedureEstrogenReceptorPositiveCellResultPercentageValue

Type de données

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25246
UMLS 2011AA Property
C1446409
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus Property-3
C12508
UMLS 2011AA Property-3
C0007634
NCI Thesaurus Property-4
C17069
UMLS 2011AA Property-4
C0034804
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
Mark an 'X' if N/A
Description

DataUnknownText

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C25474
UMLS 2011AA ObjectClass
C1511726
NCI Thesaurus Property
C17998
UMLS 2011AA Property
C0439673
PgR Status
Description

PgRStatusType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C17075
UMLS 2011AA ObjectClass
C0034833
NCI Metathesaurus Property
C0678257
PgR % cells stained positive
Description

LaboratoryProcedureProgesteroneReceptorPositiveCellResultPercentageValue

Type de données

float

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C25246
UMLS 2011AA Property
C1446409
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property-2
C1274040
NCI Thesaurus Property-3
C12508
UMLS 2011AA Property-3
C0007634
NCI Thesaurus Property-4
C17075
UMLS 2011AA Property-4
C0034833
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
Is the accession number (including block number) of the block used to determine the ER/PgR result available (reported above - check one)
Description

SpecimenEstrogenReceptorProgesteroneReceptorBlockAccessionNumberPresentInd-2

Type de données

boolean

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C25436
UMLS 2011AA Property-2
C1533157
NCI Thesaurus Property-3
C17069
UMLS 2011AA Property-3
C0034804
NCI Thesaurus Property-4
C17075
UMLS 2011AA Property-4
C0034833
NCI Thesaurus Property-5
C25402
UMLS 2011AA Property-5
C1510755
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Accession Number including a block number (on the blocks sent)
Description

SpecimenBlockAccessionNumber

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus Property
C25436
UMLS 2011AA Property
C1533157
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property-2
C25402
UMLS 2011AA Property-2
C1510755
Accession Number
Description

SpecimenAccessionNumber

Type de données

float

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25402
UMLS 2011AA Property
C1510755
Local Her2 Results
Description

Local Her2 Results

IHC Result
Description

LaboratoryProcedureHER2/neuImmunohistochemistryResultStatus

Type de données

text

Alias
NCI Thesaurus ObjectClass
C25294
UMLS 2011AA ObjectClass
C0022885
NCI Thesaurus Property
C16722
NCI Thesaurus Property-2
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-3
C17756
UMLS 2011AA Property-2
C0242957
NCI Thesaurus ValueDomain
C25688
UMLS 2011AA ValueDomain
C0449438
Percentage of Invasive Tumor Cells with Membrane Staining
Description

PathologyTissueSpecimenMembraneStainMalignantCellPercentageValue

Type de données

float

Alias
NCI Thesaurus ObjectClass
C12801
UMLS 2011AA ObjectClass
C0040300
NCI Thesaurus ObjectClass-2
C19157
UMLS 2011AA ObjectClass-2
C0370003
NCI Thesaurus ObjectClass-3
C18189
UMLS 2011AA ObjectClass-3
C0030664
NCI Thesaurus Property
C14143
UMLS 2011AA Property
C0205282
NCI Thesaurus Property-2
C12508
UMLS 2011AA Property-2
C0007634
NCI Thesaurus Property-3
C12749
UMLS 2011AA Property-3
C0025255
NCI Thesaurus Property-4
C841
UMLS 2011AA Property-4
C0038128
NCI Thesaurus ValueDomain
C25613
UMLS 2011AA ValueDomain
C0439165
NCI Thesaurus ValueDomain-2
C25712
UMLS 2011AA ValueDomain-2
C1522609
Staining Antibody
Description

PathologyTissueSpecimenAntibodyStainingMethodType

Type de données

text

Alias
NCI Thesaurus ObjectClass
C12801
UMLS 2011AA ObjectClass
C0040300
NCI Thesaurus ObjectClass-2
C19157
UMLS 2011AA ObjectClass-2
C0370003
NCI Thesaurus ObjectClass-3
C18189
UMLS 2011AA ObjectClass-3
C0030664
NCI Thesaurus Property
C16295
UMLS 2011AA Property
C0003241
NCI Thesaurus Property-2
C23010
UMLS 2011AA Property-2
C0487602
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
Other specify
Description

PathologyTissueSpecimenAntibodyStainingMethodText

Type de données

text

Alias
NCI Thesaurus ObjectClass
C12801
UMLS 2011AA ObjectClass
C0040300
NCI Thesaurus ObjectClass-2
C19157
UMLS 2011AA ObjectClass-2
C0370003
NCI Thesaurus ObjectClass-3
C18189
UMLS 2011AA ObjectClass-3
C0030664
NCI Thesaurus Property
C16295
UMLS 2011AA Property
C0003241
NCI Thesaurus Property-2
C23010
UMLS 2011AA Property-2
C0487602
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
Is the accession number (including block number) of the block used to determine the IHC HER2 result available (reported above - check one)
Description

SpecimenBlockAccessionNumberImmunohistochemistryStainingMethodHER2/neuBlockAccessionNumberPresentInd-2

Type de données

boolean

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C25436
UMLS 2011AA Property-2
C1533157
NCI Thesaurus Property-3
C23020
UMLS 2011AA Property-3
C0021044
NCI Thesaurus Property-4
C17756
UMLS 2011AA Property-4
C0242957
NCI Thesaurus Property-5
C25402
UMLS 2011AA Property-5
C1510755
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
FISH Result
Description

FISHCytologyResultType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C16491
UMLS 2011AA ObjectClass
C0010819
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
FISH HER2/neu chromosome 17 Ratio
Description

FISHAssessmentChromosome17ResultHER2NeuNumber

Type de données

float

Alias
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C13212
UMLS 2011AA Property-2
C0008659
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ValueDomain-2
C17756
UMLS 2011AA ValueDomain-2
C0242957
Chromosome 17 copy number
Description

FluorescenceinsituHybridizationDiagnosticProcedureChromosome17SignalResultCount

Type de données

text

Alias
NCI Thesaurus ObjectClass
C17563
UMLS 2011AA ObjectClass
C0162789
NCI Thesaurus ObjectClass-2
C18020
UMLS 2011AA ObjectClass-2
C0430022
NCI Thesaurus Property
C20200
UMLS 2011AA Property
C1274040
NCI Thesaurus Property-2
C13212
UMLS 2011AA Property-2
C0008659
NCI Thesaurus Property-3
C43382
UMLS 2011AA Property-3
C1710082
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
FISH Kit or Test Type
Description

FISHAssessmentTestType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C25294
UMLS 2011AA Property
C0022885
Other specify
Description

FISHAssessmentTestSpecify

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25685
UMLS 2011AA ValueDomain
C1521902
NCI Thesaurus ObjectClass
C20989
UMLS 2011AA ObjectClass
C0031809
NCI Thesaurus ObjectClass-2
C17563
UMLS 2011AA ObjectClass-2
C0162789
NCI Thesaurus Property
C25294
UMLS 2011AA Property
C0022885
Is the accession number (including block number) of the block used to determine the FISH HER2 result available (reported above - check one)
Description

SpecimenFluorescenceinsituHybridizationHER2/neuBlockAccessionNumberPresentInd-2

Type de données

boolean

Alias
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25626
UMLS 2011AA Property
C0150312
NCI Thesaurus Property-2
C17563
UMLS 2011AA Property-2
C0162789
NCI Thesaurus Property-3
C25436
UMLS 2011AA Property-3
C1533157
NCI Thesaurus Property-4
C17756
UMLS 2011AA Property-4
C0242957
NCI Thesaurus Property-5
C25402
UMLS 2011AA Property-5
C1510755
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
Specimen Type (the protocol requests one normal block and one tumor block. Please identify)
Description

SpecimenSubmittedType

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25284
UMLS 2011AA ValueDomain
C0332307
NCI Thesaurus ObjectClass
C19157
UMLS 2011AA ObjectClass
C0370003
NCI Thesaurus Property
C25695
UMLS 2011AA Property
C1515023
Comments
Description

Comments

Comments
Description

Research Comments

Type de données

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS CUI-1
C0947611
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
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1 Formulaires
  1. StudyEvent: North Central Cancer Treatment Group - Pathology Specimen Submission Form
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Type de données
Alias
Item Group
Header Module
Protocol ID NCCTG
Item
NCCTG Study No.
text
C25337 (NCI Thesaurus ValueDomain)
C3274381 (UMLS CUI-1)
C25320 (NCI Thesaurus ObjectClass)
C1518419 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
C25581 (NCI Thesaurus Property-2)
PathologyCoreFacilityLaboratoryIdentifierNumber
Item
Central Pathology ID Number
text
C37984 (NCI Thesaurus ObjectClass)
C0022877 (UMLS 2011AA ObjectClass)
C18189 (NCI Thesaurus ObjectClass-2)
C0030664 (UMLS 2011AA ObjectClass-2)
C15896 (NCI Thesaurus ObjectClass-3)
C1511521 (UMLS 2011AA ObjectClass-3)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
Patient Initials
Item
Patient Initials
text
C25191 (NCI Thesaurus ValueDomain)
C2986440 (UMLS CUI-1)
C16960 (NCI Thesaurus ObjectClass)
C25536 (NCI Thesaurus Property)
Institution Number
Item
Institution Number
text
C25337 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C0805701 (UMLS CUI-2)
C25364 (NCI Thesaurus Property)
Institution Name
Item
Institution
text
C25191 (NCI Thesaurus ValueDomain)
C1301943 (UMLS CUI-1)
C21541 (NCI Thesaurus ObjectClass)
C21541 (NCI Thesaurus ValueDomain-2)
C25364 (NCI Thesaurus Property)
Item Group
Biopsy specimen / Lab
SpecimenLabSubmittedDate
Item
Date Specimen Shipped
date
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property-2)
C1515023 (UMLS 2011AA Property-2)
SpecimenBlockSubmissionCount
Item
Number of blocks sent
text
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
C25436 (NCI Thesaurus Property)
C1533157 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25694 (NCI Thesaurus Property-2)
C1515022 (UMLS 2011AA Property-2)
Item
ER Status (Local ER/PrG Result)
text
C3262 (NCI Thesaurus ValueDomain)
C0027651 (UMLS 2011AA ValueDomain)
C17069 (NCI Thesaurus ObjectClass)
C0034804 (UMLS 2011AA ObjectClass)
C25688 (NCI Thesaurus ValueDomain-2)
C0449438 (UMLS 2011AA ValueDomain-2)
C25554 (NCI Thesaurus Property)
C0441889 (UMLS 2011AA Property)
CL.1
Code List
ER Status (Local ER/PrG Result)
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
LaboratoryProcedureEstrogenReceptorPositiveCellResultPercentageValue
Item
ER % cells stained positive
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C12508 (NCI Thesaurus Property-3)
C0007634 (UMLS 2011AA Property-3)
C17069 (NCI Thesaurus Property-4)
C0034804 (UMLS 2011AA Property-4)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
DataUnknownText
Item
Mark an 'X' if N/A
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C25474 (NCI Thesaurus ObjectClass)
C1511726 (UMLS 2011AA ObjectClass)
C17998 (NCI Thesaurus Property)
C0439673 (UMLS 2011AA Property)
Item
PgR Status
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C17075 (NCI Thesaurus ObjectClass)
C0034833 (UMLS 2011AA ObjectClass)
C0678257 (NCI Metathesaurus Property)
CL.2
Code List
PgR Status
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Not Done (NOT DONE)
CL281691 (NCI Metathesaurus)
LaboratoryProcedureProgesteroneReceptorPositiveCellResultPercentageValue
Item
PgR % cells stained positive
float
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C25246 (NCI Thesaurus Property)
C1446409 (UMLS 2011AA Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property-2)
C12508 (NCI Thesaurus Property-3)
C0007634 (UMLS 2011AA Property-3)
C17075 (NCI Thesaurus Property-4)
C0034833 (UMLS 2011AA Property-4)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
SpecimenEstrogenReceptorProgesteroneReceptorBlockAccessionNumberPresentInd-2
Item
Is the accession number (including block number) of the block used to determine the ER/PgR result available (reported above - check one)
boolean
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25436 (NCI Thesaurus Property-2)
C1533157 (UMLS 2011AA Property-2)
C17069 (NCI Thesaurus Property-3)
C0034804 (UMLS 2011AA Property-3)
C17075 (NCI Thesaurus Property-4)
C0034833 (UMLS 2011AA Property-4)
C25402 (NCI Thesaurus Property-5)
C1510755 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
SpecimenBlockAccessionNumber
Item
Accession Number including a block number (on the blocks sent)
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C25436 (NCI Thesaurus Property)
C1533157 (UMLS 2011AA Property)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25402 (NCI Thesaurus Property-2)
C1510755 (UMLS 2011AA Property-2)
SpecimenAccessionNumber
Item
Accession Number
float
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25402 (NCI Thesaurus Property)
C1510755 (UMLS 2011AA Property)
Item Group
Local Her2 Results
Item
IHC Result
text
C25294 (NCI Thesaurus ObjectClass)
C0022885 (UMLS 2011AA ObjectClass)
C16722 (NCI Thesaurus Property)
C20200 (NCI Thesaurus Property-2)
C1274040 (UMLS 2011AA Property)
C17756 (NCI Thesaurus Property-3)
C0242957 (UMLS 2011AA Property-2)
C25688 (NCI Thesaurus ValueDomain)
C0449438 (UMLS 2011AA ValueDomain)
CL.4
Code List
IHC Result
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Negative (Negative)
C25247 (NCI Thesaurus)
C0205160 (UMLS 2011AA)
CL Item
Positive (Positive)
C25246 (NCI Thesaurus)
C1446409 (UMLS 2011AA)
CL Item
Not Done (Not done / Not available)
CL281691 (NCI Metathesaurus)
PathologyTissueSpecimenMembraneStainMalignantCellPercentageValue
Item
Percentage of Invasive Tumor Cells with Membrane Staining
float
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C18189 (NCI Thesaurus ObjectClass-3)
C0030664 (UMLS 2011AA ObjectClass-3)
C14143 (NCI Thesaurus Property)
C0205282 (UMLS 2011AA Property)
C12508 (NCI Thesaurus Property-2)
C0007634 (UMLS 2011AA Property-2)
C12749 (NCI Thesaurus Property-3)
C0025255 (UMLS 2011AA Property-3)
C841 (NCI Thesaurus Property-4)
C0038128 (UMLS 2011AA Property-4)
C25613 (NCI Thesaurus ValueDomain)
C0439165 (UMLS 2011AA ValueDomain)
C25712 (NCI Thesaurus ValueDomain-2)
C1522609 (UMLS 2011AA ValueDomain-2)
Item
Staining Antibody
text
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C18189 (NCI Thesaurus ObjectClass-3)
C0030664 (UMLS 2011AA ObjectClass-3)
C16295 (NCI Thesaurus Property)
C0003241 (UMLS 2011AA Property)
C23010 (NCI Thesaurus Property-2)
C0487602 (UMLS 2011AA Property-2)
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
CL.5
Code List
Staining Antibody
CL Item
Dako Herceptest [tm] (DAKO Herceptest [TM])
CL Item
Dako A0485 (DAKO A0485)
CL Item
Cb-11/ventana Kit (CB-11/Ventana Kit)
CL Item
Tab-250 (TAB-250)
CL Item
Ncl-c-erbb2-316 (NCL-c-erbB2-316)
CL Item
Other Specify (Other)
CL Item
Ihc Not Done (IHC not done)
PathologyTissueSpecimenAntibodyStainingMethodText
Item
Other specify
text
C12801 (NCI Thesaurus ObjectClass)
C0040300 (UMLS 2011AA ObjectClass)
C19157 (NCI Thesaurus ObjectClass-2)
C0370003 (UMLS 2011AA ObjectClass-2)
C18189 (NCI Thesaurus ObjectClass-3)
C0030664 (UMLS 2011AA ObjectClass-3)
C16295 (NCI Thesaurus Property)
C0003241 (UMLS 2011AA Property)
C23010 (NCI Thesaurus Property-2)
C0487602 (UMLS 2011AA Property-2)
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
SpecimenBlockAccessionNumberImmunohistochemistryStainingMethodHER2/neuBlockAccessionNumberPresentInd-2
Item
Is the accession number (including block number) of the block used to determine the IHC HER2 result available (reported above - check one)
boolean
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C25436 (NCI Thesaurus Property-2)
C1533157 (UMLS 2011AA Property-2)
C23020 (NCI Thesaurus Property-3)
C0021044 (UMLS 2011AA Property-3)
C17756 (NCI Thesaurus Property-4)
C0242957 (UMLS 2011AA Property-4)
C25402 (NCI Thesaurus Property-5)
C1510755 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
FISH Result
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C16491 (NCI Thesaurus ObjectClass)
C0010819 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
CL.7
Code List
FISH Result
CL Item
Amplified (Amplified)
CL Item
Equivocal (Equivocal)
C86071 (NCI Thesaurus)
C0332241 (UMLS 2011AA)
CL Item
Not Amplified (Not amplified)
CL Item
Not Done (Not done)
CL281691 (NCI Metathesaurus)
FISHAssessmentChromosome17ResultHER2NeuNumber
Item
FISH HER2/neu chromosome 17 Ratio
float
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C13212 (NCI Thesaurus Property-2)
C0008659 (UMLS 2011AA Property-2)
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C17756 (NCI Thesaurus ValueDomain-2)
C0242957 (UMLS 2011AA ValueDomain-2)
Item
Chromosome 17 copy number
text
C17563 (NCI Thesaurus ObjectClass)
C0162789 (UMLS 2011AA ObjectClass)
C18020 (NCI Thesaurus ObjectClass-2)
C0430022 (UMLS 2011AA ObjectClass-2)
C20200 (NCI Thesaurus Property)
C1274040 (UMLS 2011AA Property)
C13212 (NCI Thesaurus Property-2)
C0008659 (UMLS 2011AA Property-2)
C43382 (NCI Thesaurus Property-3)
C1710082 (UMLS 2011AA Property-3)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
CL.8
Code List
Chromosome 17 copy number
CL Item
Polysomy (Polysomy)
C36331 (NCI Thesaurus)
C1514212 (UMLS 2011AA)
CL Item
Monosomy (Monosomy)
C3239 (NCI Thesaurus)
C0026499 (UMLS 2011AA)
CL Item
Normal (Normal)
C14165 (NCI Thesaurus)
C0205307 (UMLS 2011AA)
CL Item
Not Done: C49484 (Not done / Not available)
C49484 (NCI Thesaurus)
C1272696 (UMLS 2011AA)
Item
FISH Kit or Test Type
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
CL.9
Code List
FISH Kit or Test Type
CL Item
Ventana/oncorprobe[tm] (Ventana/Oncorprobe)
CL Item
Vysis Tricolor Probe (Vysis Tricolor probe)
CL Item
Ventana Inform (Ventana INFORM)
CL Item
Other Specify (Other)
CL Item
Fish Not Done (FISH not done)
FISHAssessmentTestSpecify
Item
Other specify
text
C25685 (NCI Thesaurus ValueDomain)
C1521902 (UMLS 2011AA ValueDomain)
C20989 (NCI Thesaurus ObjectClass)
C0031809 (UMLS 2011AA ObjectClass)
C17563 (NCI Thesaurus ObjectClass-2)
C0162789 (UMLS 2011AA ObjectClass-2)
C25294 (NCI Thesaurus Property)
C0022885 (UMLS 2011AA Property)
SpecimenFluorescenceinsituHybridizationHER2/neuBlockAccessionNumberPresentInd-2
Item
Is the accession number (including block number) of the block used to determine the FISH HER2 result available (reported above - check one)
boolean
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25626 (NCI Thesaurus Property)
C0150312 (UMLS 2011AA Property)
C17563 (NCI Thesaurus Property-2)
C0162789 (UMLS 2011AA Property-2)
C25436 (NCI Thesaurus Property-3)
C1533157 (UMLS 2011AA Property-3)
C17756 (NCI Thesaurus Property-4)
C0242957 (UMLS 2011AA Property-4)
C25402 (NCI Thesaurus Property-5)
C1510755 (UMLS 2011AA Property-5)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
Item
Specimen Type (the protocol requests one normal block and one tumor block. Please identify)
text
C25284 (NCI Thesaurus ValueDomain)
C0332307 (UMLS 2011AA ValueDomain)
C19157 (NCI Thesaurus ObjectClass)
C0370003 (UMLS 2011AA ObjectClass)
C25695 (NCI Thesaurus Property)
C1515023 (UMLS 2011AA Property)
CL.11
Code List
Specimen Type (the protocol requests one normal block and one tumor block. Please identify)
CL Item
Normal Block (Normal block)
CL Item
Tumor Block (Tumor block)
Item Group
Comments
Research Comments
Item
Comments
text
C25704 (NCI Thesaurus ValueDomain)
C0947611 (UMLS CUI-1)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
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