diff --git a/IRaCIS.Core.Application/Helper/FileDocProcess/ExcelExportHelper.cs b/IRaCIS.Core.Application/Helper/FileDocProcess/ExcelExportHelper.cs
index 8baf7789d..c79bf6a2e 100644
--- a/IRaCIS.Core.Application/Helper/FileDocProcess/ExcelExportHelper.cs
+++ b/IRaCIS.Core.Application/Helper/FileDocProcess/ExcelExportHelper.cs
@@ -300,6 +300,17 @@ public static class ExcelExportHelper
         {
             public Guid Id { get; set; }
             public string Name { get; set; }
+
+            public override bool Equals(object obj)
+            {
+                if (obj is not ColumItem other) return false;
+                return Id == other.Id && Name == other.Name;
+            }
+
+            public override int GetHashCode()
+            {
+                return HashCode.Combine(Id, Name);
+            }
         }
 
         public List<string> ColumnIdList => ColumnIdNameList == null ? new List<string>() : ColumnIdNameList.Select(t => t.Id.ToString()).ToList();
diff --git a/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs b/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs
index ccbf5e4d1..51c7e4496 100644
--- a/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs
+++ b/IRaCIS.Core.Application/Service/Common/ExcelExportService.cs
@@ -2400,7 +2400,7 @@ namespace IRaCIS.Core.Application.Service.Common
                         {
                             Id = Guid.Empty,
                             Name = (t.QuestionType == QuestionType.ExistDisease || t.QuestionType == QuestionType.Tumor) ? (_userInfo.IsEn_Us ? "Overall Response" : "整体肿瘤评估") : t.QuestionName
-                        }).ToList();
+                        }).Distinct().ToList();
 
 
 
@@ -2413,7 +2413,7 @@ namespace IRaCIS.Core.Application.Service.Common
                         {
                             Id = Guid.Empty,
                             Name = (t.QuestionType == QuestionType.ExistDisease || t.QuestionType == QuestionType.ImgOncology) ? (_userInfo.IsEn_Us ? "Overall Response" : "整体肿瘤评估") : t.QuestionName
-                        }).ToList();
+                        }).Distinct().ToList();
 
                     }
                     else if (criterion.CriterionType == CriterionType.PCWG3)
@@ -2422,7 +2422,7 @@ namespace IRaCIS.Core.Application.Service.Common
                         {
                             Id = Guid.Empty,
                             Name = t.QuestionName
-                        }).ToList();
+                        }).Distinct().ToList();
 
                     }