diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/Dto/CriterionCalculateDto.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/Dto/CriterionCalculateDto.cs
index caebebb9..32a82237 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/Dto/CriterionCalculateDto.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/Dto/CriterionCalculateDto.cs
@@ -11,6 +11,28 @@ namespace IRaCIS.Core.Application.ViewModel
         public Guid VisitTaskId { get; set; }
     }
 
+    public class SiteVisitForTumor
+    {
+        /// <summary>
+        /// 访视Id
+        /// </summary>
+        public Guid VisitTaskId { get; set; }
+
+        /// <summary>
+        /// 任务Num
+        /// </summary>
+        public decimal VisitTaskNum { get; set; }
+
+        /// <summary>
+        /// 最早拍片日期
+        /// </summary>
+        public DateTime EarliestScanDate { get; set; }
+
+        /// <summary>
+        /// 最晚拍片日期
+        /// </summary>
+        public DateTime LatestScanDate { get; set; }
+    }
 
     public class AddTaskLesionAnswerFromLastTaskOutDto
     {
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
index c8d42b02..50095083 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/PCWG3CalculateService.cs
@@ -437,7 +437,10 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 				// 自治疗后第二个访视点以来持续的新骨病变数量
 			    new ReadingCalculateData (){QuestionType=QuestionType.NewBoneLesionsCount,GetIntFun=GetNewBoneLesionCount},
 
-	
+                // 自治疗后第二个访视点以来持续的新骨病变数量
+			    new ReadingCalculateData (){QuestionType=QuestionType.SiteVisitForTumorEvaluation,GetStringFun=GetSiteVisitForTumorEvaluation},
+
+
 
             };
 
@@ -460,14 +463,15 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
                         #region 计算答案
 
-                        var value = await calculate.GetIntFun(inDto);
+                       
 
                         switch (calculate.QuestionType)
                         {
                             case QuestionType.NewLesionsCount:
+                               
                                 if (inDto.VisitTaskNum >= 1)
                                 {
-                                    item.Answer = value.ToString();
+                                    item.Answer = (await calculate.GetIntFun(inDto)).ToString();
                                 }
                                 else
                                 {
@@ -477,7 +481,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                             case QuestionType.AlwaysNewLesionsCount:
                                 if (inDto.VisitTaskNum >= 2)
                                 {
-                                    item.Answer = value.ToString();
+                                    item.Answer = (await calculate.GetIntFun(inDto)).ToString();
                                 }
                                 else
                                 {
@@ -487,15 +491,18 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                             case QuestionType.NewBoneLesionsCount:
                                 if (inDto.VisitTaskNum >= 3)
                                 {
-                                    item.Answer = value.ToString();
+                                    item.Answer = (await calculate.GetIntFun(inDto)).ToString();
                                 }
                                 else
                                 {
                                     item.Answer = nameof(YesOrNoOrNa.NA);
                                 }
                                 break;
+                            case QuestionType.SiteVisitForTumorEvaluation:
+                                item.Answer = await calculate.GetStringFun(inDto);
+                                break;
                             default:
-                                item.Answer = value.ToString();
+                                item.Answer =string.Empty;
                                 break;
                         }
                        
@@ -608,6 +615,111 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
         #endregion
 
+
+
+        #region 访视点肿瘤评估
+        /// <summary>
+        /// 访视点肿瘤评估
+        /// </summary>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task<string> GetSiteVisitForTumorEvaluation(ReadingCalculateDto inDto)
+        {
+            await ChangeLastTaskSiteVisitForTumorEvaluation(inDto);
+            var newLesionsCount = int.Parse(inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesionsCount).Select(x => x.Answer).FirstOrDefault() ?? "0");
+            var baseLineLesionsCount = int.Parse(inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.BaseLineLesionsCount).Select(x => x.Answer).FirstOrDefault() ?? "0");
+            var alwaysNewLesionsCount = int.Parse(inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.AlwaysNewLesionsCount).Select(x => x.Answer).FirstOrDefault() ?? "0");
+            if (newLesionsCount == 0 &&
+                baseLineLesionsCount == 0 &&
+                alwaysNewLesionsCount == 0)
+            {
+                return VisitTumorEvaluation.ND.GetEnumInt();
+            }
+            else
+            {
+                return VisitTumorEvaluation.NoPD.GetEnumInt();
+            }
+        }
+
+        /// <summary>
+        /// 修改上一次访视结果
+        /// </summary>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task ChangeLastTaskSiteVisitForTumorEvaluation(ReadingCalculateDto inDto)
+        {
+            var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).FirstNotNullAsync();
+            var taskList = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit &&
+                    x.TrialReadingCriterionId == taskinfo.TrialReadingCriterionId &&
+                    x.SubjectId == taskinfo.SubjectId && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.VisitTaskNum <= taskinfo.VisitTaskNum && x.TaskState == TaskState.Effect && x.ArmEnum == taskinfo.ArmEnum
+                    ).OrderByDescending(x => x.VisitTaskNum).Select(x => new SiteVisitForTumor()
+                    {
+                        VisitTaskId=x.Id,
+                        VisitTaskNum=x.VisitTaskNum,
+                        EarliestScanDate=x.SourceSubjectVisit.EarliestScanDate??DateTime.Now,
+                        LatestScanDate=x.SourceSubjectVisit.LatestScanDate ?? DateTime.Now,
+                    }).ToListAsync();
+            var lastTask = taskList.Where(x => x.VisitTaskNum < taskinfo.VisitTaskNum).OrderByDescending(x => x.VisitTaskNum).FirstOrDefault();
+
+            var baseLineTask = taskList.OrderBy(x => x.VisitTaskNum).FirstOrDefault();
+            var newLesionsCountQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesionsCount).Select(x => x.QuestionId).FirstOrDefault();
+
+            var isPDResult = false;
+
+            if (lastTask != null)
+            {
+                var lastTasknewLesionsCount = int.Parse(await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastTask.VisitTaskId && x.ReadingQuestionTrialId == newLesionsCountQuestionId).Select(x => x.Answer).FirstOrDefaultAsync() ?? "0");
+                if (lastTask.VisitTaskNum == 1m)
+                {
+                    //基线后第二个访视（应满足访视间隔6周以上，否则顺延）
+                    var secondVisit = taskList.Where(x => x.VisitTaskNum >= 2 && x.EarliestScanDate >= baseLineTask.LatestScanDate.AddDays(42)).FirstOrDefault();
+                    if (secondVisit != null)
+                    {
+
+                        // 第二访视数量
+                        var secondVisitLesionsCount = int.Parse(await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastTask.VisitTaskId && x.ReadingQuestionTrialId == newLesionsCountQuestionId).Select(x => x.Answer).FirstOrDefaultAsync() ?? "0");
+
+                        // 判断是否是当前访视
+                        if (secondVisit.VisitTaskId == inDto.VisitTaskId)
+                        {
+                            secondVisitLesionsCount = int.Parse(inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesionsCount).Select(x => x.Answer).FirstOrDefault() ?? "0");
+                        }
+
+                        if (lastTasknewLesionsCount >= 2 && secondVisitLesionsCount >= 2)
+                        {
+                            isPDResult = true;
+                        }
+                    }
+
+                }
+                else
+                {
+                    var thisVisitTaskNewLesionsCount= int.Parse(inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesionsCount).Select(x => x.Answer).FirstOrDefault() ?? "0");
+
+                    var thisVisitTask = taskList.LastOrDefault();
+
+                    if (lastTasknewLesionsCount >= 2 && thisVisitTaskNewLesionsCount >= 2&&lastTask.LatestScanDate.AddDays(42)<= thisVisitTask.EarliestScanDate)
+                    {
+                        isPDResult = true;
+                    }
+
+                }
+            }
+            if (isPDResult)
+            {
+                var visitForTumorEvaluationQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SiteVisitForTumorEvaluation).Select(x => x.QuestionId).FirstOrDefault();
+             
+                await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == lastTask.VisitTaskId && x.ReadingQuestionTrialId == visitForTumorEvaluationQuestionId,x=> new ReadingTaskQuestionAnswer 
+                {
+                    Answer= VisitTumorEvaluation.PD.GetEnumInt(),
+                   
+
+                });
+            }
+        }
+
+        #endregion
+
         public async Task<object> GetReportVerify(GetReportVerifyInDto inDto)
         {
             return new() { 
diff --git a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
index ef406a99..e05f586c 100644
--- a/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
+++ b/IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs
@@ -995,6 +995,43 @@ namespace IRaCIS.Core.Domain.Share
         /// 自治疗后第二个访视点以来持续的新骨病变数量
         /// </summary>
         NewBoneLesionsCount = 19,
+
+        /// <summary>
+        /// 疗效评估分组
+        /// </summary>
+        TherapeuticEffectEvaluationGroup=20,
+
+        /// <summary>
+        /// 访视点肿瘤评估
+        /// </summary>
+        SiteVisitForTumorEvaluation = 21,
+    }
+
+    /// <summary>
+    /// 访视点肿瘤评估
+    /// </summary>
+    public enum VisitTumorEvaluation
+    {
+
+        /// <summary>
+        /// PD
+        /// </summary>
+        PD = 1,
+
+        /// <summary>
+        /// ND
+        /// </summary>
+        ND = 2,
+
+        /// <summary>
+        /// NE
+        /// </summary>
+        NE = 3,
+
+        /// <summary>
+        /// 非PD
+        /// </summary>
+        NoPD = 4
     }
 
     /// <summary>