diff --git a/src/api/trials.js b/src/api/trials.js
index b8866b8..d7c8e13 100644
--- a/src/api/trials.js
+++ b/src/api/trials.js
@@ -2794,7 +2794,13 @@ export function changeDicomReadingQuestionAnswer(param) {
     data: param
   })
 }
-
+export function changeReportAnswer(param) {
+  return request({
+    url: `/ReadingImageTask/changeReportAnswer`,
+    method: 'post',
+    data: param
+  })
+}
 export function saveImageQuality(param) {
   return request({
     url: `/ReadingImageTask/saveImageQuality`,
diff --git a/src/views/trials/trials-panel/reading/dicoms/components/ReportPage.vue b/src/views/trials/trials-panel/reading/dicoms/components/ReportPage.vue
index c6685b1..4bb04e2 100644
--- a/src/views/trials/trials-panel/reading/dicoms/components/ReportPage.vue
+++ b/src/views/trials/trials-panel/reading/dicoms/components/ReportPage.vue
@@ -20,8 +20,8 @@
             <!-- 刷新 -->
             {{ $t('trials:readingReport:button:refresh') }}
           </el-button>
-          <el-button :loading="reportBtnLoading" v-if="readingTaskState >= 2" type="primary"
-            size="small" @click="showReport('evaluate')">{{ $t('trials:dicoms:button:evaluationReport') }}</el-button>
+          <el-button :loading="reportBtnLoading" v-if="readingTaskState >= 2" type="primary" size="small"
+            @click="showReport('evaluate')">{{ $t('trials:dicoms:button:evaluationReport') }}</el-button>
           <el-button :loading="reportBtnLoading" v-if="readingTaskState >= 2 && CriterionType !== 10" type="primary"
             size="small" @click="showReport('tumor')">{{ $t('trials:dicoms:button:tumorReport') }}</el-button>
           <el-button v-if="readingTaskState < 2 && CriterionType !== 10" type="primary" size="small"
@@ -48,8 +48,8 @@
               </span>
             </template>
           </el-table-column>
-          <el-table-column v-for="task in visitTaskList" :key="task.VisitTaskId" prop="date" show-overflow-tooltip
-            width="150px">
+          <el-table-column v-for="(task, index) in visitTaskList" :key="task.VisitTaskId" prop="date"
+            show-overflow-tooltip width="150px">
             <template slot="header">
               <div v-if="task.IsCurrentTask">
                 <div>
@@ -69,7 +69,46 @@
               <span
                 :style="{ color: ((scope.row.isLymphNodes === 1 && scope.row.QuestionMark === 1) || (scope.row.isLymphNodes === 0 && scope.row.QuestionMark === 0)) && (scope.row.LesionType === 0 || scope.row.LesionType === 5) || (scope.row.QuestionMark === 12) || scope.row.HighlightAnswerList.includes(`${scope.row.Answers[task.VisitTaskId]}`) ? '#f66' : '#fff' }">
                 <template
-                  v-if="task.VisitTaskId === visitTaskId && readingTaskState < 2 && [13, 14, 15, 42].includes(scope.row.QuestionType)">
+                  v-if="CriterionType === 10 && readingTaskState < 2 && [21, 14].includes(scope.row.QuestionType)">
+                  <!-- 访视点肿瘤评估（基线时不可修改） -->
+                  <template v-if="index > 0 && CriterionType === 10 && scope.row.QuestionType === 21">
+                    <el-select v-if="scope.row.Type === 'calculation' && scope.row.DictionaryCode"
+                      v-model="tumorEvaluationObj[task.VisitTaskId]" size="mini"
+                      @change="(val) => handleTumorEvaluationChange(val, task.VisitTaskId)">
+                      <el-option v-for="item of $d[scope.row.DictionaryCode]" :key="item.id" :value="item.value"
+                        :label="item.label" />
+                    </el-select>
+                  </template>
+                  <template v-else-if="index === 0 && CriterionType === 10 && scope.row.QuestionType === 21">
+                    {{ $fd(scope.row.DictionaryCode, scope.row.Answers[task.VisitTaskId]) }}
+                  </template>
+                  <template v-else-if="CriterionType === 10 && scope.row.QuestionType === 14">
+                    <!-- v-if="tumorEvaluate && (currentEvaluateResult !== tumorEvaluate || currentExistDisease !== isExistDisease)" -->
+                    <template>
+                      <!-- 输入框 -->
+                      <el-input v-if="scope.row.Type === 'input'" v-model="taskReasonObj[task.VisitTaskId]" size="mini"
+                        @change="(val) => evaluateReasonObjChange(val, task.VisitTaskId)" />
+                      <el-input v-else-if="scope.row.Type === 'textarea'" v-model="taskReasonObj[task.VisitTaskId]"
+                        :autosize="{ minRows: 2, maxRows: 4 }" size="mini" maxlength="500"
+                        @change="(val) => evaluateReasonObjChange(val, task.VisitTaskId)" />
+                      <!-- 系统评估结果为：xxx,与当前调整的结果不一致，请填写调整原因 -->
+                      <p v-if="tumorEvaluationObj[task.VisitTaskId] !== currentTumorEvaluationObj[task.VisitTaskId]"
+                        style="width: 140px;padding:0 2px;white-space: normal;word-break: break-all;word-wrap: break-word;"
+                        v-html="getWarningText(task.VisitTaskId)" />
+                      <!-- <p v-else-if="currentExistDisease !== isExistDisease"
+                        style="width: 140px;padding:0 2px;white-space: normal;word-break: break-all;word-wrap: break-word;">
+                        {{ $t('trials:readingReport:title:sysEvaluationRes') }}<span style="color:red">{{
+                          $fd('ExistDisease', isExistDisease) }}</span>{{ $t('trials:readingReport:message:msg1') }}
+                      </p> -->
+                    </template>
+                    <!-- <template v-else>
+                      <span>{{ currentTaskReason }}</span>
+                    </template> -->
+
+                  </template>
+                </template>
+                <template
+                  v-else-if="task.VisitTaskId === visitTaskId && readingTaskState < 2 && [13, 14, 15, 42].includes(scope.row.QuestionType)">
                   <!-- 是否存在疾病（基线时可修改） -->
                   <template v-if="task.IsBaseLine && scope.row.QuestionType === 15">
                     <el-select v-if="scope.row.Type === 'select' && scope.row.DictionaryCode"
@@ -221,7 +260,7 @@
         </el-form-item>
         <!-- 名称 -->
         <el-form-item :label="$t('trials:reading:label:TNMValue')" prop="TemplateName">
-          <el-input v-model="TnmForm.TNMValue" :disabled="readingTaskState >= 2"/>
+          <el-input v-model="TnmForm.TNMValue" :disabled="readingTaskState >= 2" />
         </el-form-item>
         <el-form-item style="text-align:right;" v-if="readingTaskState < 2">
           <!-- Cancel -->
@@ -238,7 +277,7 @@
   </div>
 </template>
 <script>
-import { getReadingReportEvaluation, changeDicomReadingQuestionAnswer, submitDicomVisitTask, verifyVisitTaskQuestions, getTaskAdditionalQuestion } from '@/api/trials'
+import { getReadingReportEvaluation, changeDicomReadingQuestionAnswer, changeReportAnswer, submitDicomVisitTask, verifyVisitTaskQuestions, getTaskAdditionalQuestion } from '@/api/trials'
 import { setSkipReadingCache, setTNMValue, getTNMValue } from '@/api/reading'
 import { getAutoCutNextTask } from '@/api/user'
 import DicomEvent from './DicomEvent'
@@ -282,6 +321,9 @@ export default {
       isExistDisease: null,
       currentExistDisease: null,
       currentTaskReason: '',
+      taskReasonObj: {},
+      tumorEvaluationObj: {},
+      currentTumorEvaluationObj: {},
       answerArr: [],
       questions: [],
       isShowDetail: false,
@@ -610,6 +652,19 @@ export default {
               } else {
                 obj.Answers[i.VisitTaskId] = i.Answer
               }
+              if (item.QuestionType === 14) {
+                this.$set(this.taskReasonObj, i.VisitTaskId, obj.Answers[i.VisitTaskId])
+                if (this.CriterionType === 10) {
+                  this.answerArr.push({ id: item.QuestionId, answer: obj.Answers[i.VisitTaskId], questionType: 14, visitTaskId: i.VisitTaskId })
+                }
+              }
+              if (item.QuestionType === 21) {
+                this.$set(this.tumorEvaluationObj, i.VisitTaskId, obj.Answers[i.VisitTaskId])
+                this.$set(this.currentTumorEvaluationObj, i.VisitTaskId, obj.Answers[i.VisitTaskId])
+                if (this.CriterionType === 10) {
+                  this.answerArr.push({ id: item.QuestionId, answer: obj.Answers[i.VisitTaskId], questionType: 21, visitTaskId: i.VisitTaskId })
+                }
+              }
             })
             if (item.QuestionType === 15) {
               this.currentExistDisease = obj.Answers[this.visitTaskId]
@@ -621,7 +676,9 @@ export default {
             }
             if (item.QuestionType === 14) {
               this.currentTaskReason = obj.Answers[this.visitTaskId]
-              this.answerArr.push({ id: item.QuestionId, answer: obj.Answers[this.visitTaskId], questionType: 14 })
+              if (this.CriterionType !== 10) {
+                this.answerArr.push({ id: item.QuestionId, answer: obj.Answers[this.visitTaskId], questionType: 14 })
+              }
             }
             if (item.Childrens.length >= 1) {
               obj.Childrens = this.getQuestions(item.Childrens, isNTFilterLength, lesionType, isLymphNodes)
@@ -649,6 +706,14 @@ export default {
         this.answerArr[idx].answer = val
       }
     },
+    handleTumorEvaluationChange(val, visitTaskId) {
+      this.taskReasonObj[visitTaskId] = ''
+      this.evaluateReasonObjChange('', visitTaskId)
+      var idx = this.answerArr.findIndex(i => i.questionType === 21 && i.visitTaskId === visitTaskId)
+      if (idx > -1) {
+        this.answerArr[idx].answer = val
+      }
+    },
     handleEvaluateResultChange(val) {
       // this.currentEvaluateResult = parseInt(val)
       if (val === this.tumorEvaluate && this.isExistDisease === this.currentExistDisease) {
@@ -670,6 +735,12 @@ export default {
         this.answerArr[idx].answer = val
       }
     },
+    evaluateReasonObjChange(val, visitTaskId) {
+      var idx = this.answerArr.findIndex(i => i.questionType === 14 && i.visitTaskId === visitTaskId)
+      if (idx > -1) {
+        this.answerArr[idx].answer = val
+      }
+    },
     async handleConfirm() {
       this.loading = true
       try {
@@ -827,6 +898,7 @@ export default {
         var evaluateAjustReason = ''
         this.answers = []
         var isExistEvaluateResult = false
+        let isRequired = false
         this.answerArr.map(item => {
           if (item.questionType === 13 || item.questionType === 42) {
             evaluateResult = item.answer
@@ -838,8 +910,42 @@ export default {
           if (item.questionType === 15) {
             isBeill = item.answer
           }
-          this.answers.push({ id: item.id, answer: item.answer })
+          if (this.CriterionType === 10) {
+            if (this.tumorEvaluationObj[item.visitTaskId] !== this.currentTumorEvaluationObj[item.visitTaskId] && !this.taskReasonObj[item.visitTaskId]) isRequired = true
+            this.answers.push({ questionId: item.id, answer: item.answer, visitTaskId: item.visitTaskId })
+          } else {
+            this.answers.push({ id: item.id, answer: item.answer })
+          }
+
         })
+        if (this.CriterionType === 10) {
+          if (isRequired) {
+            // 请将疗效评估信息填写完整
+            this.$confirm(this.$t('trials:readingReport:message:msg2'), {
+              type: 'warning',
+              showCancelButton: false,
+              callback: action => { }
+            })
+            reject()
+            return
+          }
+          this.loading = true
+          try {
+            var params = {
+              answerlist: this.answers
+            }
+            const res = await changeReportAnswer(params)
+            if (res.IsSuccess && isPrompt) {
+              this.$message.success(this.$t('common:message:savedSuccessfully'))
+            }
+            this.loading = false
+            resolve()
+          } catch (e) {
+            this.loading = false
+            reject()
+          }
+          return false
+        }
         console.log(this.currentExistDisease, this.isExistDisease, evaluateAjustReason, isBeill)
         if (this.currentExistDisease !== this.isExistDisease && !evaluateAjustReason) {
           this.$confirm(this.$t('trials:readingReport:message:msg2'), {
@@ -888,15 +994,15 @@ export default {
         }
       })
     },
-    getWarningText() {
+    getWarningText(visitTaskId) {
       var sysRes = ''
       var curRes = ''
       if (this.CriterionType === 2) {
         sysRes = this.$fd('ImagingOverallAssessment_Lugano', this.tumorEvaluate)
         curRes = this.$fd('ImagingOverallAssessment_Lugano', this.currentEvaluateResult)
       } else {
-        sysRes = this.$fd('OverallAssessment', this.tumorEvaluate)
-        curRes = this.$fd('OverallAssessment', this.currentEvaluateResult)
+        sysRes = this.$fd('OverallAssessment', visitTaskId ? this.tumorEvaluationObj[visitTaskId] : this.tumorEvaluate)
+        curRes = this.$fd('OverallAssessment', visitTaskId ? this.currentTumorEvaluationObj[visitTaskId] : this.currentEvaluateResult)
       }
       if (!curRes) {
         return ''