算法修改

IRaCIS.Core.Application/IRaCIS.Core.Application.xml

@@ -1437,10 +1437,57 @@
             <returns></returns>
         </member>
         <!-- Badly formed XML comment ignored for member "M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetIRECISTTargetLesionEvaluate(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)" -->
-        <member name="M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetNewTargetLesionEvaluate(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)">
+        <!-- Badly formed XML comment ignored for member "M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetIRECISTNoTargetLesionEvaluate(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)" -->
+        <!-- Badly formed XML comment ignored for member "M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetNewTargetLesionEvaluate(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)" -->
+        <!-- Badly formed XML comment ignored for member "M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetNewNoTargetLesionEvaluate(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)" -->
+        <member name="M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetOtherNewTargetLesionEvaluate(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)">
             <summary>
-            获取新靶病灶评估
+            获取其它既往新病灶评估
             </summary>
+            <remarks>
+            if（有其它既往新病灶消失或一直不存在任何其它既往新病灶） 
+            {
+               疗效为 ND
+            }
+            else if (任一病灶从非“存在”状态改为“存在”状态)
+            {
+               疗效为 iUPD
+            }
+            else if (至少有一个其它既往新病灶无法评估)
+            {
+                疗效为 NE
+            }
+            else if (至少有一个其它既往新病灶为疑似状态)
+            {
+                疗效为 疑似
+            }
+            </remarks>
+            <param name="inDto"></param>
+            <returns></returns>
+        </member>
+        <member name="M:IRaCIS.Core.Application.Service.ReadingCalculate.IRECIST1Point1CalculateService.GetNewLesionAfterTriggeringiRECSITAssessment(IRaCIS.Core.Application.Service.Reading.Dto.ReadingCalculateDto)">
+            <summary>
+            
+            </summary>
+            <remarks>
+            if现至少1个“存在”状态的触发iRECIST后新病灶） 
+            {
+               疗效为 是
+            }
+            else if (只要有一个触发iRECIST后新病灶评估为NE)
+            {
+               疗效为 NE
+            }
+            else if (只要有一个触发iRECIST后新病灶评估为疑似)
+            {
+                疗效为 疑似
+            }
+            else
+            {
+                疗效为 否
+            }
+            
+            </remarks>
             <param name="inDto"></param>
             <returns></returns>
         </member>
@@ -7229,14 +7276,59 @@
             与基线期SOD相比减小≥30 %
             </summary>
         </member>
+        <member name="T:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion">
+            <summary>
+            IRECIST 非靶病灶
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.NotExistsNoTargetLesion">
+            <summary>
+            基线未选择任何非靶病灶
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.LastNoTargetLesion">
+            <summary>
+            上次非靶病灶评估结果
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.ExistiCPD">
+            <summary>
+            任一非靶病灶状态评估为“进一步增大（iCPD）”
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.LastNoUPD">
+            <summary>
+            出现至少1个上一访视未评估为“显著增大（iUPD）”的病灶本次访视评估为“显著增大（iUPD）”
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.ExistiUPD">
+            <summary>
+             任一非靶病灶状态评估为 iUPD
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.RECISTPD">
+            <summary>
+            满足RECIST1.1PD
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.HaveNeLesion">
+            <summary>
+            有任一非靶病灶为NE状态
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNoTargetLesion.AllVanish">
+            <summary>
+            全部为消失
+            </summary>
+        </member>
         <member name="T:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto">
             <summary>
             新靶病灶评估Dto
             </summary>
         </member>
-        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto.ExistsNewTargetLesion">
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto.NotExistsNewTargetLesion">
             <summary>
-            存在新靶病灶
+            不存在新靶病灶
             </summary>
         </member>
         <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto.AllVanish">
@@ -7244,9 +7336,9 @@
             所有状态为消失
             </summary>
         </member>
-        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto.LastTaskIsiUPD">
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto.LastTaskNewTargetLesion">
             <summary>
-            上一访视新靶病灶评估为“iUPD”
+            上一访视新靶病灶评估
             </summary>
         </member>
         <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewTargetLesionDto.ISODAdd5mm">
@@ -7264,9 +7356,39 @@
             至少有一个新靶病无法评估
             </summary>
         </member>
-        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.ExistsNewNoTargetLesion">
+        <member name="T:IRaCIS.Core.Application.ViewModel.IRECISTOtherNewTargetLesionDto">
             <summary>
-            存在新非靶病灶
+            其他既往新病灶
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTOtherNewTargetLesionDto.NotExistsOtherNewTargetLesion">
+            <summary>
+            不存在其他既往新病灶
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTOtherNewTargetLesionDto.AllVanish">
+            <summary>
+            所有状态为消失
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTOtherNewTargetLesionDto.LastTaskNoExists">
+            <summary>
+            当任一病灶从非“存在”状态改为“存在”状态
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTOtherNewTargetLesionDto.ExixtsUnevaluableState">
+            <summary>
+            至少有一个病灶无法评估
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTOtherNewTargetLesionDto.ExixtsSuspectedState">
+            <summary>
+            至少有一个其它既往新病灶为疑似状态
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.NotExistsNewNoTargetLesion">
+            <summary>
+            不存在新非靶病灶
             </summary>
         </member>
         <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.AllVanish">
@@ -7274,9 +7396,14 @@
             所有状态为消失
             </summary>
         </member>
-        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.LastTaskIsiUPD">
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.LastTaskNewNoTargetLesion">
             <summary>
-            上一访视新靶病灶评估为“iUPD”
+            上一访视新非靶病灶评估
+            </summary>
+        </member>
+        <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.NewTargetLesion">
+            <summary>
+            当前访视的新靶病灶评估
             </summary>
         </member>
         <member name="P:IRaCIS.Core.Application.ViewModel.IRECISTNewNoTargetLesionDto.ExixtsEnlargementState">

IRaCIS.Core.Application/Service/ReadingCalculate/Dto/CriterionCalculateDto.cs

@@ -107,7 +107,51 @@ namespace IRaCIS.Core.Application.ViewModel
 
     }
 
-  
+    /// <summary>
+    /// IRECIST 非靶病灶
+    /// </summary>
+    public class IRECISTNoTargetLesion
+    {
+        /// <summary>
+        /// 基线未选择任何非靶病灶
+        /// </summary>
+        public bool NotExistsNoTargetLesion { get; set; }
+
+        /// <summary>
+        /// 上次非靶病灶评估结果
+        /// </summary>
+        public string LastNoTargetLesion { get; set; }
+
+        /// <summary>
+        /// 任一非靶病灶状态评估为“进一步增大（iCPD）”
+        /// </summary>
+        public bool ExistiCPD { get; set; }
+
+        /// <summary>
+        /// 出现至少1个上一访视未评估为“显著增大（iUPD）”的病灶本次访视评估为“显著增大（iUPD）”
+        /// </summary>
+        public bool LastNoUPD { get; set; }
+
+        /// <summary>
+        ///  任一非靶病灶状态评估为 iUPD
+        /// </summary>
+        public bool ExistiUPD { get; set; }
+
+        /// <summary>
+        /// 满足RECIST1.1PD
+        /// </summary>
+        public bool RECISTPD { get; set; }
+
+        /// <summary>
+        /// 有任一非靶病灶为NE状态
+        /// </summary>
+        public bool HaveNeLesion { get; set; }
+
+        /// <summary>
+        /// 全部为消失
+        /// </summary>
+        public bool AllVanish { get; set; }
+    }
 
     /// <summary>
     /// 新靶病灶评估Dto
@@ -115,9 +159,9 @@ namespace IRaCIS.Core.Application.ViewModel
     public class IRECISTNewTargetLesionDto
     {
         /// <summary>
-        /// 存在新靶病灶
+        /// 不存在新靶病灶
         /// </summary>
-        public bool ExistsNewTargetLesion { get; set; }
+        public bool NotExistsNewTargetLesion { get; set; }
 
         /// <summary>
         /// 所有状态为消失
@@ -125,9 +169,9 @@ namespace IRaCIS.Core.Application.ViewModel
         public bool AllVanish { get; set; }
 
         /// <summary>
-        /// 上一访视新靶病灶评估为“iUPD”
+        /// 上一访视新靶病灶评估
         /// </summary>
-        public bool LastTaskIsiUPD { get; set; }
+        public string LastTaskNewTargetLesion { get; set; }
 
         /// <summary>
         /// SOD增加5mm以上
@@ -145,12 +189,51 @@ namespace IRaCIS.Core.Application.ViewModel
         public bool ExixtsUnevaluableState { get; set; }
     }
 
+    /// <summary>
+    /// 其他既往新病灶
+    /// </summary>
+    public class IRECISTOtherNewTargetLesionDto
+    {
+        /// <summary>
+        /// 不存在其他既往新病灶
+        /// </summary>
+        public bool NotExistsOtherNewTargetLesion { get; set; }
+
+        /// <summary>
+        /// 所有状态为消失
+        /// </summary>
+        public bool AllVanish { get; set; }
+
+        /// <summary>
+        /// 当任一病灶从非“存在”状态改为“存在”状态
+        /// </summary>
+        public bool LastTaskNoExists { get; set; }
+
+        /// <summary>
+        /// 至少有一个病灶无法评估
+        /// </summary>
+        public bool ExixtsUnevaluableState { get; set; }
+
+        /// <summary>
+        /// 至少有一个其它既往新病灶为疑似状态
+        /// </summary>
+        public bool ExixtsSuspectedState { get; set; }
+    }
+
+    ///// <summary>
+    ///// 触发iRECIST后新病灶评估
+    ///// </summary>
+    //public class NewLesionAfterTriggeringiRECSITAssessmentDto
+    //{
+        
+    //}
+
     public class IRECISTNewNoTargetLesionDto
     {
         /// <summary>
-        /// 存在新非靶病灶
+        /// 不存在新非靶病灶
         /// </summary>
-        public bool ExistsNewNoTargetLesion { get; set; }
+        public bool NotExistsNewNoTargetLesion { get; set; }
 
         /// <summary>
         /// 所有状态为消失
@@ -159,9 +242,14 @@ namespace IRaCIS.Core.Application.ViewModel
 
 
         /// <summary>
-        /// 上一访视新靶病灶评估为“iUPD”
+        /// 上一访视新非靶病灶评估
         /// </summary>
-        public bool LastTaskIsiUPD { get; set; }
+        public string LastTaskNewNoTargetLesion { get; set; }
+
+        /// <summary>
+        /// 当前访视的新靶病灶评估
+        /// </summary>
+        public string NewTargetLesion { get; set; }
 
         /// <summary>
         /// 任一新非靶病灶状态为“增大”

IRaCIS.Core.Application/Service/ReadingCalculate/IRECIST1Point1CalculateService.cs

@@ -1545,10 +1545,16 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         /// if（基线没有靶病灶） 
         /// {
         ///      靶病灶疗效为 ND
-        /// }else if ((上一访视评估为iCPD && 本次访视满足RECIST1.1的PD条件)|| 上一访视评估为iUPD || 本次访视SOD增加不小于5mm)
+        /// }
+        /// else if (上一访视评估为iCPD && 本次访视满足RECIST1.1的PD条件&&比整体访视期间最低点SOD增加≥20%&&比整体访视期间最低点SOD绝对增加值≥5 mm)
         /// {
         ///     靶病灶疗效为 ICPD
-        /// } else if (本次访视满足RECIST1.1的PD条件 && (比整体访视期间最低点SOD增加≥20 % && 比整体访视期间最低点SOD绝对增加值≥5 mm)|| (前一访视评估为iCR && 当前访视至少有一个“存在”状态的靶病灶))
+        /// } 
+        /// else if (上一访视评估为iUPD||本次访视SOD增加不小于5mm)
+        /// {
+        ///     靶病灶疗效为 ICPD
+        /// } 
+        /// else if (本次访视满足RECIST1.1的PD条件 && (比整体访视期间最低点SOD增加≥20 % && 比整体访视期间最低点SOD绝对增加值≥5 mm)|| (前一访视评估为iCR && 当前访视至少有一个“存在”状态的靶病灶))
         /// {
         ///     靶病灶疗效为 iUPD
         /// } else if (有任一靶病灶为NE状态)
@@ -1639,18 +1645,24 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
                 //      靶病灶疗效为 ND
                 result = TargetAssessment.ND;
             }
-            // }else if ((上一访视评估为iCPD && 本次访视满足RECIST1.1的PD条件)|| 上一访视评估为iUPD || 本次访视SOD增加不小于5mm)
+            // else if (上一访视评估为iCPD && 本次访视满足RECIST1.1的PD条件&&比整体访视期间最低点SOD增加≥20%&&比整体访视期间最低点SOD绝对增加值≥5 mm)
-            else if ((resultData.LastTaskTarget.EqEnum(OverallAssessment.iCPD) && resultData.MeetRECISTPD) || resultData.LastTaskTarget.EqEnum(OverallAssessment.iUPD) || resultData.SODAddGreaterThan5)
+            else if (resultData.LastTaskTarget.EqEnum(OverallAssessment.iCPD) && resultData.MeetRECISTPD && resultData.LowSodAddGreaterThan20Percent && resultData.LowSodAddGreaterThan5)
+            {
+                //     靶病灶疗效为 ICPD
+                result = TargetAssessment.iCPD;
+            }
+            // else if (上一访视评估为iUPD||本次访视SOD增加不小于5mm)
+            else if (resultData.LastTaskTarget.EqEnum(OverallAssessment.iUPD) || resultData.SODAddGreaterThan5)
             {
                 //     靶病灶疗效为 ICPD
                 result = TargetAssessment.iCPD;
             }
             // } else if (本次访视满足RECIST1.1的PD条件 && (比整体访视期间最低点SOD增加≥20 % && 比整体访视期间最低点SOD绝对增加值≥5 mm)|| (前一访视评估为iCR && 当前访视至少有一个“存在”状态的靶病灶))
-            else if(resultData.MeetRECISTPD&&(resultData.LowSodAddGreaterThan20Percent&&resultData.LowSodAddGreaterThan5)|| (resultData.LastTaskTarget.EqEnum(OverallAssessment.iCR)&&resultData.HaveExistLesion))
+            else if (resultData.MeetRECISTPD && (resultData.LowSodAddGreaterThan20Percent && resultData.LowSodAddGreaterThan5) || (resultData.LastTaskTarget.EqEnum(OverallAssessment.iCR) && resultData.HaveExistLesion))
             {
                 //     靶病灶疗效为 iUPD
                 result = TargetAssessment.iUPD;
-            } 
+            }
             // else if (有任一靶病灶为NE状态)
             else if(resultData.HaveNeLesion)
              {
@@ -1683,11 +1695,164 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
 
         #region IRECIST非靶病灶评估
 
+        /// <summary>
+        /// IRECIST非靶病灶评估
+        /// </summary>
+        /// <remarks>
+        /// if（基线没有非靶病灶） 
+        /// {
+        ///    非靶病灶疗效为 ND
+        /// }
+        /// else if (上次非靶病灶评估结果为非iUPD && (任一非靶病灶状态评估为“进一步增大（iCPD）||出现至少1个上一访视未评估为“显著增大（iUPD）”的病灶本次访视评估为“显著增大（iUPD）”))
+        /// {
+        ///    非靶病灶疗效为 iCPD
+        /// }
+        /// else if (上次非靶病灶评估结果为非iCPD && 任一非靶病灶状态评估为“进一步增大（iCPD）”或“显著增大（iUPD）”)
+        /// {
+        ///     非靶病灶疗效为 iCPD
+        /// }
+        /// else if (满足RECIST1.1的PD标准 && 任一非靶病灶状态评估为“显著增大（iUPD）”)
+        /// {
+        ///     非靶病灶疗效为 iUPD
+        /// }
+        /// else if (有任一非靶病灶为NE状态)
+        /// {
+        ///     非靶病灶疗效为 NE
+        /// }
+        /// else if (全部非靶病灶均为“消失”状态)
+        /// {
+        ///     非靶病灶疗效为 iCR
+        /// }
+        /// else
+        /// {
+        ///     非靶病灶疗效为 iNN
+        /// }
+        /// </remarks>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task<string> GetIRECISTNoTargetLesionEvaluate(ReadingCalculateDto inDto)
+        {
+            var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList).ToList();
+            var lastVisitTaskId = await GetLastVisitTaskId(inDto);
+            var noTargetQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NoTargetLesion).Select(x => x.QuestionId).FirstOrDefault();
+
+            // 找上一次任务 未被评为显著增大的非靶病灶
+            ReadingCalculateDto lastTaskCalculateDto = await _generalCalculateService.GetReadingCalculateDto(lastVisitTaskId);
+
+            var lastTaskNoiUPDIndexs = lastTaskCalculateDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList)
+               .Where(x => x.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && !x.Answer.EqEnum(NoTargetState.IUPD))).Select(x => x.RowIndex).ToList();
+
+
+            IRECISTNoTargetLesion data = new IRECISTNoTargetLesion()
+            {
+                // 基线没有非靶病灶
+                NotExistsNoTargetLesion = tableQuestion.Count() == 0,
+
+                // 上次非靶病灶评估结果
+                LastNoTargetLesion = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == noTargetQuestionId)
+                .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty,
+
+                // 任一非靶病灶状态评估为“进一步增大（iCPD）”
+                ExistiCPD = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.ICPD)),
+
+                // 出现至少1个上一访视未评估为“显著增大（iUPD）”的病灶本次访视评估为“显著增大（iUPD）”
+                LastNoUPD = tableQuestion.Where(x => lastTaskNoiUPDIndexs.Contains(x.RowIndex)).SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.IUPD)),
+
+                // 任一非靶病灶状态评估为 iUPD
+                ExistiUPD = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.IUPD)),
+
+                // 满足RECIST1.1PD
+                RECISTPD = (await GetNoTargetLesionEvaluate(inDto)).EqEnum(NoTargetAssessment.PD),
+
+                // 有任一非靶病灶为NE状态
+                HaveNeLesion = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.UnableEvaluate)),
+
+                // 全部为消失
+                AllVanish = true,
+            };
+
+
+            foreach (var item in tableQuestion)
+            {
+                data.AllVanish = data.AllVanish && item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Loss));
+            }
+
+            NoTargetAssessment result = NoTargetAssessment.iNN;
+
+            // if（基线没有非靶病灶） 
+            if (data.NotExistsNoTargetLesion)
+            {
+                //    非靶病灶疗效为 ND
+                result = NoTargetAssessment.ND;
+            }
+            // else if (上次非靶病灶评估结果为非iUPD && (任一非靶病灶状态评估为“进一步增大（iCPD）||出现至少1个上一访视未评估为“显著增大（iUPD）”的病灶本次访视评估为“显著增大（iUPD）”))
+            else if (!data.LastNoTargetLesion.EqEnum(NoTargetAssessment.iUPD) && (data.ExistiCPD || data.LastNoUPD))
+            {
+                //    非靶病灶疗效为 iCPD
+                result = NoTargetAssessment.iCPD;
+            }
+            // else if (上次非靶病灶评估结果为非iCPD && 任一非靶病灶状态评估为“进一步增大（iCPD）”或“显著增大（iUPD）”)
+            else if (!data.LastNoTargetLesion.EqEnum(NoTargetAssessment.iCPD) && (data.ExistiCPD || data.ExistiUPD))
+            {
+                //     非靶病灶疗效为 iCPD
+                result = NoTargetAssessment.iCPD;
+            }
+            // else if (满足RECIST1.1的PD标准 && 任一非靶病灶状态评估为“显著增大（iUPD）”)
+            else if (data.RECISTPD && data.ExistiUPD)
+            {
+                //     非靶病灶疗效为 iUPD
+                result = NoTargetAssessment.iUPD;
+            }
+            // else if (有任一非靶病灶为NE状态)
+            else if (data.HaveNeLesion)
+            {
+                //     非靶病灶疗效为 NE
+                result = NoTargetAssessment.NE;
+            }
+            // else if (全部非靶病灶均为“消失”状态)
+            else if (data.AllVanish)
+            {
+                //     非靶病灶疗效为 iCR
+                result = NoTargetAssessment.iCR;
+            }
+            // else
+            else
+            {
+                //     非靶病灶疗效为 iNN
+                result = NoTargetAssessment.iNN;
+            }
+
+            return result.GetEnumInt();
+        }
         #endregion
 
+        #region IRECIST新靶病灶评估
+
         /// <summary>
-        /// 获取新靶病灶评估
+        /// 获取IRECIST新靶病灶评估
         /// </summary>
+        /// <remarks>
+        /// if（所有新靶病灶消失或一直不存在任何新靶病灶） 
+        /// {
+        ///    疗效为 ND
+        /// }
+        /// else if (上一访视新靶病灶评估为“iUPD” && 满足iSOD增加5mm)
+        /// {
+        ///    疗效为 iCPD
+        /// }
+        /// else if (上一访视新靶病灶评估为“iCPD”&& 有"存在"状态的新靶病灶)
+        /// {
+        ///     疗效为 iCPD
+        /// }
+        /// else if (有存在状态的新靶病灶时评估为该结果)
+        /// {
+        ///     疗效为 iUPD
+        /// }
+        /// else if (至少有一个新靶病无法评估)
+        /// {
+        ///     疗效为 NE
+        /// }
+        /// </remarks>
         /// <param name="inDto"></param>
         /// <returns></returns>
         public async Task<string> GetNewTargetLesionEvaluate(ReadingCalculateDto inDto)
@@ -1697,33 +1862,322 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
             {
                 return TargetAssessment.NA.GetEnumInt();
             }
-
+            var lastVisitTaskId = await GetLastVisitTaskId(inDto);
-            IRECISTNewTargetLesionDto resultData = new IRECISTNewTargetLesionDto()
+            var newTargetLesionQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewTargetLesion).Select(x => x.QuestionId).FirstOrDefault();
+            var sodQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SOD).Select(x => x.QuestionId).FirstOrDefault();
+            IRECISTNewTargetLesionDto data = new IRECISTNewTargetLesionDto()
             {
-                // 是否存在新靶病灶
+                // 不存在新靶病灶
-                ExistsNewTargetLesion = tableQuestion.Count() > 0,
+                NotExistsNewTargetLesion = tableQuestion.Count() == 0,
 
                 // 所有状态为消失
-                AllVanish = false,
+                AllVanish = true,
 
-                // 上一访视新靶病灶评估为“iUPD”
+                // 上一访视新靶病灶评估
-                LastTaskIsiUPD = true,
+                LastTaskNewTargetLesion = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == newTargetLesionQuestionId)
+                .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty,
 
                 //SOD增加5mm以上
-                ISODAdd5mm = true,
+                ISODAdd5mm = await GetSODData(inDto) - (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == sodQuestionId)
+                .Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0() >= 5,
 
                 //有"存在"状态的新靶病灶
-                HaveExixtsState = true,
+                HaveExixtsState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Exist)),
 
                 // 至少有一个新靶病无法评估
-                ExixtsUnevaluableState = true,
+                ExixtsUnevaluableState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Exist)),
 
             };
 
-            return string.Empty;
+
+            foreach (var item in tableQuestion)
+            {
+                data.AllVanish = data.AllVanish && item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Loss));
+            }
+
+            NewTargetLesionAssessment result = NewTargetLesionAssessment.NE;
+
+            // if（所有新靶病灶消失或一直不存在任何新靶病灶） 
+            if(data.NotExistsNewTargetLesion||data.AllVanish)
+             {
+                //    疗效为 ND
+                result = NewTargetLesionAssessment.ND;
+             }
+            // else if (上一访视新靶病灶评估为“iUPD” && 满足iSOD增加5mm)
+            else if(data.LastTaskNewTargetLesion.EqEnum(NewTargetLesionAssessment.iUPD)&&data.ISODAdd5mm)
+             {
+                //    疗效为 iCPD
+                result = NewTargetLesionAssessment.iCPD;
+            }
+            // else if (上一访视新靶病灶评估为“iCPD”&& 有"存在"状态的新靶病灶)
+            else if (data.LastTaskNewTargetLesion.EqEnum(NewTargetLesionAssessment.iCPD) && data.HaveExixtsState)
+             {
+                //     疗效为 iCPD
+                result = NewTargetLesionAssessment.iCPD;
+            }
+            // else if (有存在状态的新靶病灶时评估为该结果)
+            else if ( data.HaveExixtsState)
+             {
+                //     疗效为 iUPD
+                result = NewTargetLesionAssessment.iUPD;
+            }
+            // else if (至少有一个新靶病无法评估)
+            else if (data.ExixtsUnevaluableState)
+            {
+                //     疗效为 NE
+                result = NewTargetLesionAssessment.iUPD;
+            }
+
+            return result.GetEnumInt();
         }
         #endregion
 
+        #region 获取新非靶病灶评估
+        /// <summary>
+        /// 获取新非靶病灶评估
+        /// </summary>
+        /// <remarks>
+        /// if（所有新非靶病灶消失或一直不存在任何新非靶病灶时评估为该结果） 
+        /// {
+        ///    疗效为 ND
+        /// }
+        /// else if (上一访视新非靶病灶评估为“iUPD” && 满足任一新非靶病灶状态为“增大”)
+        /// {
+        ///    疗效为 iCPD
+        /// }
+        /// else if (上一访视新非靶病灶评估为“iCPD”&& 有"存在"状态的新非靶病灶)
+        /// {
+        ///     疗效为 iCPD
+        /// }
+        /// else if (当有存在状态的新非靶病灶)
+        /// {
+        ///     疗效为 iUPD
+        /// }
+        /// else if (至少有一个新非靶病无法评估)
+        /// {
+        ///     疗效为 NE
+        /// }
+        /// </remarks>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task<string> GetNewNoTargetLesionEvaluate(ReadingCalculateDto inDto)
+        {
+            var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewNonTargetLesion).SelectMany(x => x.TableRowInfoList).ToList();
+
+            var newTargetLesionQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewTargetLesion).Select(x => x.QuestionId).FirstOrDefault();
+            var lastVisitTaskId = await GetLastVisitTaskId(inDto);
+            var newNoTargetLesionQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewNoTargetLesion).Select(x => x.QuestionId).FirstOrDefault();
+            IRECISTNewNoTargetLesionDto data = new IRECISTNewNoTargetLesionDto()
+            {
+                // 不存在新非靶病灶
+                NotExistsNewNoTargetLesion = tableQuestion.Count() == 0,
+
+                // 所有状态为消失
+                AllVanish = tableQuestion.Count() == tableQuestion.Where(x => x.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.Loss))).Count(),
+
+                // 上一访视新非靶病灶评估
+                LastTaskNewNoTargetLesion = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == newNoTargetLesionQuestionId)
+                .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty,
+
+                //当前访视的新靶病灶评估
+                NewTargetLesion = inDto.QuestionInfo.Where(x=>x.QuestionId== newTargetLesionQuestionId).Select(x=>x.Answer).FirstIsNullReturnEmpty(),
+
+                // 任一新非靶病灶状态为“增大”
+                ExixtsEnlargementState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.Progression)),
+
+                // 有"存在"状态的病灶
+                HaveExixtsState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.Exist)),
+
+                // 至少有一个病灶无法评估
+                ExixtsUnevaluableState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.NotEvaluable)),
+            };
+
+            NewNoTargetLesionAssessment result = NewNoTargetLesionAssessment.NE;
+
+            // if（所有新非靶病灶消失或一直不存在任何新非靶病灶时评估为该结果） 
+            if(data.NotExistsNewNoTargetLesion|| data.AllVanish)
+             {
+                //    疗效为 ND
+                result = NewNoTargetLesionAssessment.ND;
+             }
+            // else if (上一访视新非靶病灶评估为“iUPD” && 满足任一新非靶病灶状态为“增大”)
+            else  if(data.LastTaskNewNoTargetLesion.EqEnum(NewNoTargetLesionAssessment.iUPD)&& data.ExixtsEnlargementState)
+             {
+                //    疗效为 iCPD
+                result = NewNoTargetLesionAssessment.iCPD;
+            }
+            // else if (上一访视新非靶病灶评估为“iCPD”&& 有"存在"状态的新非靶病灶)
+            else if (data.LastTaskNewNoTargetLesion.EqEnum(NewNoTargetLesionAssessment.iCPD) && data.HaveExixtsState)
+             {
+                //     疗效为 iCPD
+                result = NewNoTargetLesionAssessment.iCPD;
+            }
+            // else if (当有存在状态的新非靶病灶)
+            else if (data.HaveExixtsState)
+             {
+                //     疗效为 iUPD
+                result = NewNoTargetLesionAssessment.iUPD;
+            }
+            // else if (至少有一个新非靶病无法评估)
+            else if(data.ExixtsUnevaluableState)
+             {
+                //     疗效为 NE
+                result = NewNoTargetLesionAssessment.NE;
+            }
+
+            return result.GetEnumInt();
+        }
+        #endregion
+
+        #region 其它既往新病灶评估
+        /// <summary>
+        /// 获取其它既往新病灶评估
+        /// </summary>
+        /// <remarks>
+        /// if（有其它既往新病灶消失或一直不存在任何其它既往新病灶） 
+        /// {
+        ///    疗效为 ND
+        /// }
+        /// else if (任一病灶从非“存在”状态改为“存在”状态)
+        /// {
+        ///    疗效为 iUPD
+        /// }
+        /// else if (至少有一个其它既往新病灶无法评估)
+        /// {
+        ///     疗效为 NE
+        /// }
+        /// else if (至少有一个其它既往新病灶为疑似状态)
+        /// {
+        ///     疗效为 疑似
+        /// }
+        /// </remarks>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task<string> GetOtherNewTargetLesionEvaluate(ReadingCalculateDto inDto)
+        {
+            var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.OtherPreviousNewLesion).SelectMany(x => x.TableRowInfoList).ToList();
+
+            var lastVisitTaskId = await GetLastVisitTaskId(inDto);
+       
+
+            // 找上一次任务 未被评为显著增大的非靶病灶
+            ReadingCalculateDto lastTaskCalculateDto = await _generalCalculateService.GetReadingCalculateDto(lastVisitTaskId);
+
+            var lastTaskNoExistIndexs = lastTaskCalculateDto.QuestionInfo.Where(x => x.LesionType == LesionType.OtherPreviousNewLesion).SelectMany(x => x.TableRowInfoList)
+               .Where(x => x.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && !x.Answer.EqEnum(OtherPreviousNewLesionState.Exists))).Select(x => x.RowIndex).ToList();
+
+            IRECISTOtherNewTargetLesionDto data = new IRECISTOtherNewTargetLesionDto()
+            {
+                // 不存在其他既往新病灶
+                NotExistsOtherNewTargetLesion = tableQuestion.Count() == 0,
+
+                // 所有状态为消失
+                AllVanish = tableQuestion.Count() == tableQuestion.Where(x => x.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Loss))).Count(),
+
+                // 当任一病灶从非“存在”状态改为“存在”状态
+                LastTaskNoExists = tableQuestion.Where(x => lastTaskNoExistIndexs.Contains(x.RowIndex)).SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Exists)),
+
+                // 至少有一个病灶无法评估
+                ExixtsUnevaluableState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.NotEvaluable)),
+
+                // 至少有一个其它既往新病灶为疑似状态
+                ExixtsSuspectedState = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Equivocal)),
+
+            };
+
+            OtherPreviousNewLesionAssessment result = OtherPreviousNewLesionAssessment.Equivocal;
+
+            // if（有其它既往新病灶消失或一直不存在任何其它既往新病灶） 
+            if (data.NotExistsOtherNewTargetLesion || data.AllVanish)
+            {
+                //    疗效为 ND
+                result = OtherPreviousNewLesionAssessment.ND;
+            }
+            // else if (任一病灶从非“存在”状态改为“存在”状态)
+            else if (data.LastTaskNoExists)
+            {
+                //    疗效为 iUPD
+                result = OtherPreviousNewLesionAssessment.iUPD;
+            }
+            // else if (至少有一个其它既往新病灶无法评估)
+            else if (data.ExixtsUnevaluableState)
+            {
+                //     疗效为 NE
+                result = OtherPreviousNewLesionAssessment.NE;
+            }
+            // else if (至少有一个其它既往新病灶为疑似状态)
+            else if (data.ExixtsSuspectedState)
+            {
+                //     疗效为 疑似
+                result = OtherPreviousNewLesionAssessment.Equivocal;
+            }
+
+            return result.GetEnumInt();
+
+        }
+        #endregion
+
+        #region 触发iRECIST后新病灶评估
+        /// <summary>
+        /// 
+        /// </summary>
+        /// <remarks>
+        /// if现至少1个“存在”状态的触发iRECIST后新病灶） 
+        /// {
+        ///    疗效为 是
+        /// }
+        /// else if (只要有一个触发iRECIST后新病灶评估为NE)
+        /// {
+        ///    疗效为 NE
+        /// }
+        /// else if (只要有一个触发iRECIST后新病灶评估为疑似)
+        /// {
+        ///     疗效为 疑似
+        /// }
+        /// else
+        /// {
+        ///     疗效为 否
+        /// }
+        /// 
+        /// </remarks>
+        /// <param name="inDto"></param>
+        /// <returns></returns>
+        public async Task<string> GetNewLesionAfterTriggeringiRECSITAssessment(ReadingCalculateDto inDto)
+        {
+            var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TriggeringIRECSIT).SelectMany(x => x.TableRowInfoList).ToList();
+
+            NewLesionAfterTriggeringiRECSITAssessment result = NewLesionAfterTriggeringiRECSITAssessment.No;
+
+            // if现至少1个“存在”状态的触发iRECIST后新病灶） 
+            if (tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Exist)))
+            {
+                //    疗效为 是
+                result = NewLesionAfterTriggeringiRECSITAssessment.Yes;
+            }
+            // else if (只要有一个触发iRECIST后新病灶评估为NE)
+            else if (tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.NotEvaluable)))
+            {
+                //    疗效为 NE
+                result = NewLesionAfterTriggeringiRECSITAssessment.NE;
+            }
+            // else if (只要有一个触发iRECIST后新病灶评估为疑似)
+            else if (tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Equivocal)))
+            {
+                //     疗效为 疑似
+                result = NewLesionAfterTriggeringiRECSITAssessment.Equivocal;
+            }
+            // else
+            else
+            {
+                //     疗效为 否
+                result = NewLesionAfterTriggeringiRECSITAssessment.No;
+            }
+
+            return result.GetEnumInt();
+        }
+        #endregion
+        #endregion
+
 
 
         #region 获取靶病灶评估

IRaCIS.Core.Domain.Share/Reading/ReadEnum.cs

@@ -438,6 +438,106 @@ namespace IRaCIS.Core.Domain.Share
         Yes = 1
     }
 
+    /// <summary>
+    /// 其他既往新病灶状态
+    /// </summary>
+    public enum OtherPreviousNewLesionState
+    {
+        /// <summary>
+        /// 存在
+        /// </summary>
+        Exists = 0,
+
+        /// <summary>
+        /// 疑似
+        /// </summary>
+        Equivocal = 1,
+
+        /// <summary>
+        /// 无法评估
+        /// </summary>
+        NotEvaluable = 2,
+
+        /// <summary>
+        /// 消失
+        /// </summary>
+        Loss = 3,
+    }
+
+    /// <summary>
+    /// 其他既往新病灶评估
+    /// </summary>
+    public enum OtherPreviousNewLesionAssessment
+    {
+
+        iUPD = 1,
+
+        iCPD = 2,
+
+        /// <summary>
+        /// 疑似
+        /// </summary>
+        Equivocal = 3,
+
+        NE = 4,
+
+        ND = 5,
+    }
+
+    /// <summary>
+    /// 触发iRECIST后新病灶状态
+    /// </summary>
+    public enum NewLesionAfterTriggeringiRECSITState
+    {
+        /// <summary>
+        /// 存在
+        /// </summary>
+        Exist=1,
+
+        /// <summary>
+        /// 疑似
+        /// </summary>
+        Equivocal=2,
+      
+        /// <summary>
+        /// 消失
+        /// </summary>
+        Loss =3,
+
+        /// <summary>
+        /// 无法评估
+        /// </summary>
+        NotEvaluable = 4,
+
+    }
+
+    /// <summary>
+    /// 触发iRECIST后新病灶评估
+    /// </summary>
+    public enum NewLesionAfterTriggeringiRECSITAssessment
+    {
+
+        /// <summary>
+        /// 是
+        /// </summary>
+        Yes = 1,
+
+        /// <summary>
+        /// 否
+        /// </summary>
+        No = 2,
+
+        /// <summary>
+        /// 疑似
+        /// </summary>
+        Equivocal = 3,
+
+        /// <summary>
+        /// NE
+        /// </summary>
+        NE = 4
+    }
+
     /// <summary>
     /// 整体肿瘤评估
     /// </summary>
@@ -598,7 +698,12 @@ namespace IRaCIS.Core.Domain.Share
         /// </summary>
         NN = 4,
 
-      
+        iCR = 5,
+
+        iNN = 6,
+        iUPD = 7,
+        iCPD = 8,
+
     }
 
     /// <summary>
@@ -1051,6 +1156,64 @@ namespace IRaCIS.Core.Domain.Share
         UpdateType = 3
     }
 
+    /// <summary>
+    /// 新靶病灶状态
+    /// </summary>
+    public enum NewTargetLesionState
+    {
+        /// <summary>
+        /// 存在
+        /// </summary>
+        Exist=1,
+
+        /// <summary>
+        /// 消失
+        /// </summary>
+        Loss=2,
+
+        /// <summary>
+        /// 无法评估
+        /// </summary>
+        NotEvaluable=3,
+    }
+
+    /// <summary>
+    /// 新非靶病灶状态
+    /// </summary>
+    public enum NewNoTargetLesionState
+    {
+        /// <summary>
+        /// 存在
+        /// </summary>
+        Exist = 1,
+
+        /// <summary>
+        /// 增大
+        /// </summary>
+        Progression = 1,
+
+        /// <summary>
+        /// 无法评估
+        /// </summary>
+        NotEvaluable = 2,
+
+        /// <summary>
+        /// 消失
+        /// </summary>
+        Loss = 3,
+    }
+
+    /// <summary>
+    /// 新非靶病灶评估
+    /// </summary>
+    public enum NewNoTargetLesionAssessment
+    {
+        iUPD = 1,
+        iCPD = 2,
+        NE = 3,
+        ND = 4,
+    }
+
     public enum QuestionMark
     {
         /// <summary>
@@ -1277,6 +1440,24 @@ namespace IRaCIS.Core.Domain.Share
         IsConverted = 44,
     }
 
+    /// <summary>
+    /// 新靶病灶评估
+    /// </summary>
+    public enum NewTargetLesionAssessment
+    {
+
+        iUPD = 1,
+
+
+        iCPD = 2,
+
+
+        NE = 3,
+
+
+        ND = 4,
+    }
+
     /// <summary>
     /// 访视点肿瘤评估
     /// </summary>