diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
index 425327950..4471b153b 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs
@@ -2539,7 +2539,7 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         /// {
         ///     疗效为 iUPD
         /// }
-        /// else if ((靶病灶评估为iCR || 非靶病灶评估为iCR) && 新病灶评估为ND)
+        /// else if ((靶病灶评估为iCR && 非靶病灶评估为iCR && 新病灶评估为ND) && (靶病灶评估为ND && 非靶病灶评估为iCR && 新病灶评估为ND) && (靶病灶评估为iCR && 非靶病灶评估为ND && 新病灶评估为ND))
         /// {
         ///     疗效为 iCR
         /// }
@@ -2638,14 +2638,26 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                 //     疗效为 iUPD
                 result = OverallAssessment.iUPD;
             }
-            // else if ((靶病灶评估为iCR||靶病灶评估为ND) && (非靶病灶评估为iCR||非靶病灶评估为ND)) && 新病灶评估为ND)
-            else if (((inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iCR))
-                || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.ND)) )
-              &&
-               (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iCR))
-                || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.ND))
-               ))
-               && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND))
+            // 
+            // else if ((靶病灶评估为iCR && 非靶病灶评估为iCR && 新病灶评估为ND) && (靶病灶评估为ND && 非靶病灶评估为iCR && 新病灶评估为ND) && (靶病灶评估为iCR && 非靶病灶评估为ND && 新病灶评估为ND))
+            else if (
+
+                (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iCR))
+                && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iCR))
+                && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND))
+                )
+             ||
+
+                (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.ND))
+                && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iCR))
+                && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND))
+                )
+                 ||
+
+                (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iCR))
+                && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.ND))
+                && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND))
+                )
                 )
             {
                 //     疗效为 iCR