Baak J P, Kurver P H
Department of Pathology, Free University Hospital, Amsterdam, the Netherlands.
Anal Quant Cytol Histol. 1988 Jun;10(3):214-8.
Since histologic sections of pathologically changed tissues (e.g., tumors and inflammations) are highly complex structures, their subjective diagnostic or prognostic interpretation may result in a lack of interobserver and intraobserver agreement. Rule-based expert systems have the advantages that they require precise representation of the problem and can be used quickly and efficiently, even if the user is not acquainted with the special field concerned. Because of these and other advantages, a rule-based "Pathology Expert Consultation System" (PECS) is under development for the assessment of different premalignancies, malignancies and noncancerous conditions. In addition to supporting diagnosis making, the expert system can infer stage, type and grade, can check for inconsistencies in the answers and can predict the prognosis of an individual patient. PECS permits total integration of information contained in database, worksheet and text files with the rules and other control structures inherent in the rule base. The consultation can be interrupted to display a graph; when the user dismisses the graph, the consultation will resume where it left off or will move to another part of the system (if desired). If the user asks why a question is raised, the system will answer with a textual, graphic or combined explanation. The construction and use of the PECS expert system is discussed. Its initial applications to tumors of the lung, breast and endometrium have shown it to have both educational and clinical significance.
由于病理改变组织（如肿瘤和炎症）的组织学切片是高度复杂的结构，对其进行主观的诊断或预后解读可能会导致观察者间和观察者内缺乏一致性。基于规则的专家系统具有这样的优势：它们要求对问题进行精确表示，并且即使用户不熟悉相关特定领域也能快速高效地使用。由于这些以及其他优势，一个基于规则的“病理学专家咨询系统”（PECS）正在开发中，用于评估不同的癌前病变、恶性肿瘤和非癌性疾病。除了支持诊断外，该专家系统还可以推断分期、类型和分级，可以检查答案中的不一致之处，并可以预测个体患者的预后。PECS允许将数据库、工作表和文本文件中包含的信息与规则库中固有的规则和其他控制结构完全集成。咨询过程可以中断以显示图表；当用户关闭图表时，咨询将从中断处继续，或者（如果需要）转移到系统的另一部分。如果用户询问提出某个问题的原因，系统将以文本、图形或组合解释的形式进行回答。本文讨论了PECS专家系统的构建和使用。其在肺癌、乳腺癌和子宫内膜癌肿瘤方面的初步应用已表明它具有教育和临床意义。
