diff --git a/IRaCIS.Core.Application/IRaCIS.Core.Application.xml b/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
index 1da83f575..1accf30d6 100644
--- a/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
+++ b/IRaCIS.Core.Application/IRaCIS.Core.Application.xml
@@ -1771,6 +1771,13 @@
             <param name="inDto"></param>
             <returns></returns>
         </member>
+        <member name="M:IRaCIS.Core.Application.Service.ReadingCalculate.LuganoCalculateService.CalculateMergeTargetLesionStatus(IRaCIS.Core.Application.ViewModel.CalculateTargetLesionStatusInDto)">
+            <summary>
+            计算融合靶病灶的状态
+            </summary>
+            <param name="inDto"></param>
+            <returns></returns>
+        </member>
         <member name="M:IRaCIS.Core.Application.Service.ReadingCalculate.LuganoCalculateService.CalculateTargetLesionStatus(IRaCIS.Core.Application.ViewModel.CalculateTargetLesionStatusInDto)">
             <summary>
             计算靶病灶状态
diff --git a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
index f22e2b2fe..620042d14 100644
--- a/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
+++ b/IRaCIS.Core.Application/Service/Reading/ReadingImageTask/ReadingImageTaskService.cs
@@ -1435,7 +1435,7 @@ namespace IRaCIS.Application.Services
                 QuestionMark.MajorAxis,
                 QuestionMark.ShortAxis,
                 QuestionMark.State,
-
+			    QuestionMark.PPD,
 			};
 
             tableAnswers.ForEach(x =>
@@ -1468,6 +1468,7 @@ namespace IRaCIS.Application.Services
         {
 			await VerifyTaskIsSign(inDto.VisitTaskId);
 			await this.VerifyIsBaseLineTask(inDto.VisitTaskId);
+            var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.MergeMainRowId).Include(x => x.TrialReadingCriterion).FirstNotNullAsync();
 			var mergeRow = await _readingTableAnswerRowInfoRepository.Where(x => x.Id == inDto.MergeMainRowId).Include(x => x.ReadingQuestionTrial).FirstNotNullAsync();
 
             var mark = mergeRow.ReadingQuestionTrial.OrderMark + mergeRow.RowIndex.GetLesionMark();
@@ -1496,6 +1497,19 @@ namespace IRaCIS.Application.Services
 				VisitTaskId = inDto.VisitTaskId,
 				ComputationTrigger = ComputationTrigger.Lesion,
 			});
+
+			// 保存完了计算疾病进展
+			switch (taskinfo.TrialReadingCriterion.CriterionType)
+			{
+				case CriterionType.Lugano2014:
+					await _luganoCalculateService.CalculateMergeTargetLesionStatus(new CalculateTargetLesionStatusInDto()
+					{
+						QuestionId = inDto.QuestionId,
+						VisitTaskId = inDto.VisitTaskId,
+						RowNumber = mergeRow.RowIndex,
+					});
+					break;
+			}
 		}
 
         /// <summary>
@@ -1863,7 +1877,7 @@ namespace IRaCIS.Application.Services
                     throw new BusinessValidationFailedException(_localizer["ReadingImage_Idnotcorrespond"]);
                 }
             }
-            var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Include(x => x.TrialReadingCriterion).FirstNotNullAsync();
+            var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Include(x => x.TrialReadingCriterion).Include(x => x.SourceSubjectVisit).FirstNotNullAsync();
             inDto.BlindName = taskinfo.TaskBlindName;
             switch (taskinfo.TrialReadingCriterion.CriterionType)
             {
@@ -1993,9 +2007,9 @@ namespace IRaCIS.Application.Services
 
                         var targetlymphQuestion = targetTablequestionList.Where(x => x.QuestionMark == QuestionMark.IsLymph).FirstOrDefault();
 
-                    // 判断是否存在淋巴结问题
-                    if (targetlymphQuestion != null)
-                    {
+					// 判断是否存在淋巴结问题
+					if (targetlymphQuestion != null && taskinfo.SourceSubjectVisit.VisitNum == 0)
+					{
                         // 判断是否为淋巴结
                         if (inDto.QuestionId == targetTablequestionList[0].ReadingQuestionId && inDto.AnswerList.Any(x => x.TableQuestionId == targetlymphQuestion.Id && x.Answer.EqEnum(ReadingYesOrNo.No)))
                         {
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/Interface/ILuganoCalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/Interface/ILuganoCalculateService.cs
index 6ee6012e7..81624907a 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/Interface/ILuganoCalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/Interface/ILuganoCalculateService.cs
@@ -15,5 +15,12 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate.Interface
 		/// <param name="inDto"></param>
 		/// <returns></returns>
 		Task CalculateTargetLesionStatus(CalculateTargetLesionStatusInDto inDto);
+
+		/// <summary>
+		/// 计算靶病灶融合后状态
+		/// </summary>
+		/// <param name="inDto"></param>
+		/// <returns></returns>
+		Task CalculateMergeTargetLesionStatus(CalculateTargetLesionStatusInDto inDto);
 	}
 }
diff --git a/IRaCIS.Core.Application/Service/ReadingCalculate/LuganoCalculateService.cs b/IRaCIS.Core.Application/Service/ReadingCalculate/LuganoCalculateService.cs
index 402bb334d..42c162eaa 100644
--- a/IRaCIS.Core.Application/Service/ReadingCalculate/LuganoCalculateService.cs
+++ b/IRaCIS.Core.Application/Service/ReadingCalculate/LuganoCalculateService.cs
@@ -869,11 +869,117 @@ namespace IRaCIS.Core.Application.Service.ReadingCalculate
         }
 
         /// <summary>
-        /// 计算靶病灶状态
+        /// 计算融合靶病灶的状态
         /// </summary>
         /// <param name="inDto"></param>
         /// <returns></returns>
-        public async Task CalculateTargetLesionStatus(CalculateTargetLesionStatusInDto inDto)
+        public async Task CalculateMergeTargetLesionStatus(CalculateTargetLesionStatusInDto inDto)
+        {
+			var taskInfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).FirstNotNullAsync();
+
+			// 找到靶病灶问题
+			var targetQuestion = await _readingQuestionTrialRepository.Where(x => x.ReadingQuestionCriterionTrialId == taskInfo.TrialReadingCriterionId && x.LesionType == LesionType.TargetLesion).FirstOrDefaultAsync();
+			if (targetQuestion != null)
+			{
+				// 找到状态问题
+				var stateQuestion = await _readingTableQuestionTrialRepository.Where(x => x.ReadingQuestionId == targetQuestion.Id && x.QuestionMark == QuestionMark.State).FirstOrDefaultAsync();
+				if (stateQuestion != null)
+				{
+
+					// 找到主病灶的状态
+					var state = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && x.RowIndex == (int)Math.Floor(inDto.RowNumber) && x.TableQuestionId == stateQuestion.Id).Select(x => x.Answer).FirstOrDefaultAsync();
+
+					// 长径
+					var majorAxis = (await _readingTableQuestionAnswerRepository.Where(x =>
+					x.VisitTaskId == inDto.VisitTaskId &&
+					x.RowIndex == (int)Math.Floor(inDto.RowNumber) &&
+					x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.MajorAxis &&
+					x.QuestionId == targetQuestion.Id
+					).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0();
+
+					// 短径
+					var shortAxis = (await _readingTableQuestionAnswerRepository.Where(x =>
+					x.VisitTaskId == inDto.VisitTaskId &&
+					x.RowIndex == (int)Math.Floor(inDto.RowNumber) &&
+					x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.ShortAxis &&
+					x.QuestionId == targetQuestion.Id
+					).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0();
+
+					// 找到ppd问题
+					var ppdQuestion = await _readingTableQuestionTrialRepository.Where(x => x.ReadingQuestionId == targetQuestion.Id && x.QuestionMark == QuestionMark.PPD).FirstOrDefaultAsync();
+
+					if (ppdQuestion != null)
+					{
+						var pPdAnswer = (await _readingTableQuestionAnswerRepository.Where(x =>
+						   x.VisitTaskId == inDto.VisitTaskId &&
+						   x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.PPD &&
+						   x.QuestionId == targetQuestion.Id &&
+						   x.RowIndex == inDto.RowNumber
+						   ).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0();
+
+
+						// 是否符合疾病进展
+						var accord = false;
+
+						var lowPPDInfo = await GetLowPPDInfo(new GetPPDInfoInDto()
+						{
+							RowIndex = (int)Math.Floor(inDto.RowNumber),
+							VisitTaskId = inDto.VisitTaskId,
+							QuestionId = inDto.QuestionId,
+						});
+
+
+						if (lowPPDInfo.NadirPPD != 0)
+						{
+							//当前融合靶病灶LDi>15 mm  &&
+							//(当前融合靶病灶的ppd-最低点PPD)/最低点PPD ≥50 %
+
+							if (majorAxis >= 15 &&
+								(pPdAnswer - lowPPDInfo.NadirPPD) * 100 / lowPPDInfo.NadirPPD >= 50 
+							{
+								accord = true;
+							}
+						}
+
+						// 符合疾病进展
+						if (accord)
+						{
+							await _readingTableQuestionAnswerRepository.UpdatePartialFromQueryAsync(x =>
+							x.VisitTaskId == inDto.VisitTaskId &&
+							x.RowIndex == inDto.RowNumber &&
+							x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State &&
+							x.QuestionId == targetQuestion.Id, x => new ReadingTableQuestionAnswer()
+							{
+								Answer = TargetState.DiseaseProgression.GetEnumInt()
+							}
+							);
+						}
+						else if (state == TargetState.DiseaseProgression.GetEnumInt())
+						{
+							await _readingTableQuestionAnswerRepository.UpdatePartialFromQueryAsync(x =>
+								x.VisitTaskId == inDto.VisitTaskId &&
+								x.RowIndex == inDto.RowNumber &&
+								x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State &&
+								x.QuestionId == targetQuestion.Id, x => new ReadingTableQuestionAnswer()
+								{
+									Answer = TargetState.Exist.GetEnumInt()
+								}
+								);
+						}
+
+
+					}
+				}
+
+			}
+		}
+
+		/// <summary>
+		/// 计算靶病灶状态
+		/// </summary>
+		/// <param name="inDto"></param>
+		/// <returns></returns>
+		public async Task CalculateTargetLesionStatus(CalculateTargetLesionStatusInDto inDto)
         {
             if (inDto.RowNumber % 1 != 0)
             {