using IRaCIS.Core.Application.Service.Reading.Dto; using IRaCIS.Core.Domain.Share; using Microsoft.AspNetCore.Mvc; using IRaCIS.Core.Domain.Models; using IRaCIS.Core.Application.Interfaces; using IRaCIS.Core.Application.ViewModel; using Panda.DynamicWebApi.Attributes; using IRaCIS.Core.Infra.EFCore.Common; using Microsoft.Extensions.Caching.Memory; using Microsoft.Extensions.Logging; using IRaCIS.Core.Infrastructure; using MassTransit; using System.Linq; using System.Text; namespace IRaCIS.Core.Application.Service.ReadingCalculate { [ApiExplorerSettings(GroupName = "Reading")] public class IRECIST1Point1CalculateService : BaseService, ICriterionCalculateService { private readonly IRepository _readingTableQuestionAnswerRepository; private readonly IRepository _visitTaskRepository; private readonly IRepository _readingQuestionCriterionTrialRepository; private readonly IRepository _readingTableQuestionTrialRepository; private readonly IRepository _readingTableAnswerRowInfoRepository; private readonly IRepository _readingQuestionTrialRepository; private readonly IRepository _organInfoRepository; private readonly IRepository _subjectVisitRepository; private readonly IRepository _tumorAssessmentRepository; private readonly IGeneralCalculateService _generalCalculateService; private readonly IRepository _readingTaskQuestionAnswerRepository; private readonly ILogger _logger; public IRECIST1Point1CalculateService( IRepository readingTableQuestionAnswerRepository, IRepository visitTaskRepository, IRepository readingQuestionCriterionTrialRepository, IRepository readingTableQuestionTrialRepository, IRepository readingTableAnswerRowInfoRepository, IRepository readingQuestionTrialRepository, IRepository organInfoRepository, IRepository subjectVisitRepository, IRepository tumorAssessmentRepository, IGeneralCalculateService generalCalculateService, ILogger logger, IRepository readingTaskQuestionAnswerRepository ) { this._readingTableQuestionAnswerRepository = readingTableQuestionAnswerRepository; this._visitTaskRepository = visitTaskRepository; this._readingQuestionCriterionTrialRepository = readingQuestionCriterionTrialRepository; this._readingTableQuestionTrialRepository = readingTableQuestionTrialRepository; this._readingTableAnswerRowInfoRepository = readingTableAnswerRowInfoRepository; this._readingQuestionTrialRepository = readingQuestionTrialRepository; this._organInfoRepository = organInfoRepository; this._subjectVisitRepository = subjectVisitRepository; this._tumorAssessmentRepository = tumorAssessmentRepository; this._generalCalculateService = generalCalculateService; this._readingTaskQuestionAnswerRepository = readingTaskQuestionAnswerRepository; this._logger = logger; } #region 临时对象 单个请求的生命周期 避免重复查询数据库 private List visitTaskAnswerList; /// /// 获取Sod的值 /// private decimal? sODData; /// /// 获取iSod的值 /// private decimal? iSODData; private string nAString = "NA"; /// /// 上一次访视Id /// public Guid? lastVisitTaskId; /// /// 首次转变的任务ID /// public Guid? firstChangeTaskId; /// /// 触发任务list /// public List? compareTaskList = null; #endregion #region 删除病灶获取起始病灶序号 /// /// 删除病灶获取起始病灶序号（RECIST1Point1 固定是1） /// /// public async Task GetDeleteLesionStatrIndex(DeleteReadingRowAnswerInDto inDto) { return 1; } #endregion #region 获取阅片报告 /// /// 获取阅片报告 /// /// /// [HttpPost] public async Task GetReadingReportEvaluation(GetReadingReportEvaluationInDto indto) { GetReadingReportEvaluationOutDto result = new GetReadingReportEvaluationOutDto(); var isConvertTask = await _visitTaskRepository.Where(x => x.Id == indto.VisitTaskId).Select(x => x.IsConvertedTask).FirstNotNullAsync(); var visitTaskInfo = await _visitTaskRepository.Where(x => x.Id == indto.VisitTaskId).FirstNotNullAsync(); result.CalculateResult = await this.GetReportVerify(new GetReportVerifyInDto() { VisitTaskId = indto.VisitTaskId, IsConvertTask= isConvertTask, BeforeConvertedTaskId =visitTaskInfo.BeforeConvertedTaskId, }); result.ReadingTaskState = visitTaskInfo.ReadingTaskState; var taskInfoList = await _generalCalculateService.GetReadingReportTaskList(indto.VisitTaskId); result.VisitTaskList = taskInfoList; var visitTaskIds = taskInfoList.Select(x => x.VisitTaskId).ToList(); var criterionId = visitTaskInfo.TrialReadingCriterionId; var questionList = await _readingQuestionTrialRepository.Where(x => x.ReadingQuestionCriterionTrialId == criterionId&&x.ShowQuestion!= ShowQuestion.Hide) .WhereIf(isConvertTask,x=>x.ConvertShowType==ConvertShowType.All||x.ConvertShowType==ConvertShowType.AfterShow) .WhereIf(!isConvertTask, x => x.ConvertShowType == ConvertShowType.All || x.ConvertShowType == ConvertShowType.BeforeShow) .ToListAsync(); var tableQuestionList = await _readingTableQuestionTrialRepository.Where(x => x.TrialCriterionId == criterionId).OrderBy(x => x.ShowOrder).ToListAsync(); var tableAnsweRowInfos = await _readingTableAnswerRowInfoRepository.Where(x => x.VisitTaskId == indto.VisitTaskId).ProjectTo(_mapper.ConfigurationProvider).ToListAsync(); result.LesionCountList = tableAnsweRowInfos.GroupBy(x => x.LesionType).Select(x => new LesionDto { LesionType = x.Key!.Value, Count = x.ToList().Count() }).ToList(); var lesionsIndexs = await _readingTableAnswerRowInfoRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).GroupBy(x => new { x.QuestionId }).Select(x => new lesionsIndexDto() { QuestionId = x.Key.QuestionId, Rowindexs = x.Select(x => x.RowIndex).Distinct().OrderBy(x => x).ToList() }).ToListAsync(); var answers = await _readingTaskQuestionAnswerRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).ToListAsync(); var tableAnswers = await _readingTableQuestionAnswerRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).ToListAsync(); var alltableAnsweRowInfos = await _readingTableAnswerRowInfoRepository.Where(x => visitTaskIds.Contains(x.VisitTaskId)).ToListAsync(); var organIds = alltableAnsweRowInfos.Where(x => x.OrganInfoId != null).Select(x => x.OrganInfoId).Distinct().ToList(); var organInfos = await _organInfoRepository.Where(x => organIds.Contains(x.Id)).ToListAsync(); var needChangeType = new List() { QuestionMark.Organ, QuestionMark.Location, QuestionMark.Part, }; // 第一级 #region 构造问题 List questions = questionList.Where(x => x.Type == ReadingQestionType.Group).OrderBy(x => x.ShowOrder).Select(x => new ReadingReportDto() { QuestionId = x.Id, GroupName = x.GroupName, GroupEnName=x.GroupEnName, IsShowInDicom = x.IsShowInDicom, Type = x.Type, GroupId=x.GroupId, QuestionType = x.QuestionType, LesionType = x.LesionType, QuestionGenre = x.QuestionGenre, DataSource = x.DataSource, DictionaryCode = x.DictionaryCode, TypeValue = x.TypeValue, QuestionName = x.QuestionName.LanguageName(x.QuestionEnName, _userInfo.IsEn_Us), ShowOrder = x.ShowOrder, ValueType = x.ValueType, Unit = x.Unit, CustomUnit=x.CustomUnit, ReportLayType= ReportLayType.Group, }).ToList(); // 分组 foreach (var item in questions) { item.Childrens = questionList.Where(x => x.GroupId==item.QuestionId).OrderBy(x => x.ShowOrder).Select(x => new ReadingReportDto() { GroupName = x.GroupName, QuestionId = x.Id, IsShowInDicom = x.IsShowInDicom, GroupEnName=x.GroupEnName, QuestionName = x.QuestionName.LanguageName(x.QuestionEnName, _userInfo.IsEn_Us), LesionType = x.LesionType, QuestionGenre = x.QuestionGenre, DataSource = x.DataSource, DictionaryCode = x.DictionaryCode, Type = x.Type, QuestionType = x.QuestionType, TypeValue = x.TypeValue, ShowOrder = x.ShowOrder, OrderMark = x.OrderMark, ValueType = x.ValueType, Unit = x.Unit, CustomUnit=x.CustomUnit, ReportLayType = ReportLayType.Question, }).ToList(); // 问题 foreach (var question in item.Childrens) { foreach (var task in taskInfoList) { var answer = answers.Where(x => x.VisitTaskId == task.VisitTaskId && x.ReadingQuestionTrialId == question.QuestionId).FirstOrDefault(); question.Answer.Add(new TaskQuestionAnswer() { Answer = answer==null?string.Empty:answer.Answer, IsGlobalChange = answer == null ? false : answer.IsGlobalChange, GlobalChangeAnswer = answer == null ? string.Empty : answer.GlobalChangeAnswer, TaskName = task.TaskName, VisitTaskId = task.VisitTaskId, }); } // 构造表格行数据 var rowlist = tableAnsweRowInfos.Where(x => x.QuestionId == question.QuestionId).OrderBy(x => x.RowIndex).ToList(); question.Childrens = new List(); var rowoindexs = lesionsIndexs.Where(x => x.QuestionId == question.QuestionId).Select(x => x.Rowindexs.OrderBy(y => y).ToList()).FirstOrDefault(); rowoindexs = rowoindexs == null ? new List() : rowoindexs; foreach (var rowoindex in rowoindexs) { var rowinfo = rowlist.Where(x => x.RowIndex == rowoindex).FirstOrDefault(); question.Childrens.Add(new ReadingReportDto() { QuestionName = question.OrderMark + rowoindex.GetLesionMark(), RowId = rowinfo?.Id, IsShowInDicom = question.IsShowInDicom, SplitOrMergeLesionName = rowinfo != null ? (rowinfo.MergeName.IsNullOrEmpty() ? rowinfo.SplitName : rowinfo.MergeName) : string.Empty, SplitOrMergeType = rowinfo != null ? (rowinfo.SplitOrMergeType) : null, LesionType = question.LesionType, IsCanEditPosition = rowinfo != null ? (rowinfo.IsCanEditPosition) : false, RowIndex = rowoindex, BlindName = rowinfo != null ? rowinfo.BlindName : string.Empty, ReportLayType = ReportLayType.Lesions, ReportMark = rowinfo != null ? rowinfo.ReportMark : string.Empty, }) ; } foreach (var row in question.Childrens) { // tableQuestion row.Childrens = tableQuestionList.Where(x => x.ReadingQuestionId == question.QuestionId).Select(x => new ReadingReportDto() { QuestionName = x.QuestionName.LanguageName(x.QuestionEnName, _userInfo.IsEn_Us), QuestionId = x.ReadingQuestionId, TableQuestionId = x.Id, Type = x.Type, LesionType = question.LesionType, TableQuestionType = x.TableQuestionType, RowId=row.RowId, IsShowInDicom = question.IsShowInDicom, DataSource = x.DataSource, DictionaryCode = x.DictionaryCode, QuestionMark = x.QuestionMark, TypeValue = x.TypeValue, RowIndex = row.RowIndex, ShowOrder = x.ShowOrder, ValueType = x.ValueType, Unit = x.Unit, ReportLayType = ReportLayType.TableQuestion, }).ToList(); foreach (var tableQuestion in row.Childrens) { foreach (var task in taskInfoList) { var rowinfo = alltableAnsweRowInfos.Where(x => x.VisitTaskId == task.VisitTaskId && x.QuestionId == tableQuestion.QuestionId && x.RowIndex == tableQuestion.RowIndex).FirstOrDefault(); var taskQuestionAnswer = new TaskQuestionAnswer() { Answer = tableAnswers.Where(x => x.VisitTaskId == task.VisitTaskId && x.QuestionId == tableQuestion.QuestionId && x.RowIndex == tableQuestion.RowIndex && x.TableQuestionId == tableQuestion.TableQuestionId).Select(x => x.Answer).FirstIsNullReturnEmpty(), TaskName = task.TaskName, VisitTaskId = task.VisitTaskId, }; if (rowinfo != null && rowinfo.OrganInfoId != null) { var organInfo = organInfos.Where(x => x.Id == rowinfo.OrganInfoId).FirstOrDefault(); if (organInfo != null && needChangeType.Contains(tableQuestion.QuestionMark)) { if (_userInfo.IsEn_Us) { switch (tableQuestion.QuestionMark) { case QuestionMark.Organ: taskQuestionAnswer.Answer= organInfo.TULOCEN; break; case QuestionMark.Location: if (organInfo.IsCanEditPosition) { } else { taskQuestionAnswer.Answer = organInfo.TULATEN; } break; case QuestionMark.Part: taskQuestionAnswer.Answer = organInfo.PartEN; break; } } else { switch (tableQuestion.QuestionMark) { case QuestionMark.Organ: taskQuestionAnswer.Answer = organInfo.TULOC; break; case QuestionMark.Location: if (organInfo.IsCanEditPosition) { } else { taskQuestionAnswer.Answer = organInfo.TULAT; } break; case QuestionMark.Part: taskQuestionAnswer.Answer = organInfo.Part; break; } } } } tableQuestion.Answer.Add(taskQuestionAnswer); } } } }; } #endregion result.TaskQuestions = questions; return result; } #endregion /// /// 测试计算 /// /// /// /// [HttpGet] public async Task TestCalculate(Guid visitTaskId, QuestionType? type) { //_logger.LogError("测试计算"); ReadingCalculateDto readingData = await _generalCalculateService.GetReadingCalculateDto(visitTaskId); // await _generalCalculateService.LogRecord(readingData, "其他既往新病灶", LesionType.OtherPreviousNewLesion); if (type == null) { await ReadingCalculate(readingData); } else { await ReadingCalculate(readingData, new List() { type.Value }); } } /// /// 计算任务 /// /// /// [HttpPost] public async Task CalculateTask(CalculateTaskInDto inDto) { ReadingCalculateDto readingData = await _generalCalculateService.GetReadingCalculateDto(inDto.VisitTaskId); readingData.IsChangeOtherTask = inDto.IsChangeOtherTask; await ReadingCalculate(readingData); } /// /// 获取报告验证的信息(这里每个标准可能不一样 返回用object) /// /// /// public async Task GetReportVerify(GetReportVerifyInDto inDto) { var tumorEvaluate = string.Empty; var readingCalculateDto= await _generalCalculateService.GetReadingCalculateDto(inDto.VisitTaskId); if (!inDto.IsConvertTask) { tumorEvaluate = await GetTumor(readingCalculateDto); } else if (inDto.BeforeConvertedTaskId != null) { tumorEvaluate = await GetConvertingTumor(readingCalculateDto); } else { tumorEvaluate = await GetIRECSITTargetLesionEvaluate(readingCalculateDto); } return new GetReportVerifyOutDto() { TumorEvaluate = tumorEvaluate, IsExistDisease = await this.GetReportIsExistDisease(inDto.VisitTaskId), }; } /// /// 自动计算 /// /// /// /// public async Task ReadingCalculate(ReadingCalculateDto inDto,List? calculateType=null) { #region 计算 这里顺序非常重要 后面计算的值要依赖前面计算的结果 var needAddList = new List(); List calculateList = new List() { //靶病灶径线之和（SOD） new ReadingCalculateData (){QuestionType=QuestionType.SOD,GetDecimalNullFun=GetSODData}, //非淋巴结靶病灶长径之和 new ReadingCalculateData (){QuestionType=QuestionType.SumOfDiameter,GetDecimalNullFun=GetSumOfDiameter}, //与基线SOD相比变化量（mm） new ReadingCalculateData (){QuestionType=QuestionType.SODChange,GetDecimalNullFun=GetSODChange}, //与基线访视相比SOD变化百分比 new ReadingCalculateData (){QuestionType=QuestionType.SODPercent,GetDecimalNullFun=GetSODPercent}, //与整个访视期间SOD最低点相比增加的值（mm） new ReadingCalculateData (){QuestionType=QuestionType.LowestIncrease,GetDecimalNullFun=GetLowestIncrease,/*ChangeAllTaskFun=ChangeAllLowestIncrease*/}, //与整个访视期间SOD最低点相比增加的百分比 new ReadingCalculateData (){QuestionType=QuestionType.LowPercent,GetDecimalNullFun=GetLowPercent,/*ChangeAllTaskFun=ChangeAllLowPercent*/}, //整个访视期间SOD最低点访视名称 new ReadingCalculateData (){QuestionType=QuestionType.LowVisit,GetStringFun=GetLowVisit,/*ChangeAllTaskFun=ChangeAllLowVisitName*/}, //是否存在非淋巴结靶病灶 new ReadingCalculateData (){QuestionType=QuestionType.IsLymphTarget,GetStringFun=GetIsLymphTarget}, //是否存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上 new ReadingCalculateData (){QuestionType=QuestionType.IsAddFive,GetStringFun=GetIsAddFive}, //被评估为NE的单个靶病灶 new ReadingCalculateData (){QuestionType=QuestionType.NETarget,GetStringFun=GetNETarget}, // 与触发iRECIST访视相比SOD变化量 new ReadingCalculateData (){QuestionType=QuestionType.ComparedTriggeringSODChange,GetStringFun=GetComparedTriggeringSODChange,IsConvertedTask=true}, // 新靶病灶直径之和（iSOD） new ReadingCalculateData (){QuestionType=QuestionType.ISOD,GetDecimalNullFun=GetiSODData,IsConvertedTask=true}, // 与触发iRECIST访视相比iSOD变化量 new ReadingCalculateData (){QuestionType=QuestionType.ComparedTriggeringiSODChange,GetStringFun=GetComparedTriggeringiSODChange,IsConvertedTask=true}, // 靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.TargetLesion,GetStringFun=GetTargetLesionEvaluate,IsConvertedTask=false}, // IRECIST靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.TargetLesion,GetStringFun=GetIRECISTTargetLesionEvaluate,IsConvertedTask=true}, // 转化时靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.TargetLesion,GetStringFun=GetConvertingTargetLesionEvaluate,IsConvertedTask=true,IsBeTransforming=true}, //非靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NoTargetLesion,GetStringFun=GetNoTargetLesionEvaluate,IsConvertedTask=false}, //IRECIST非靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NoTargetLesion,GetStringFun=GetIRECISTNoTargetLesionEvaluate,IsConvertedTask=true}, // 转化时非靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NoTargetLesion,GetStringFun=GetConvertingNoTargetLesionEvaluate,IsConvertedTask=true ,IsBeTransforming=true}, // IRECIST新靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NewTargetLesion,GetStringFun=GetNewTargetLesionEvaluate,IsConvertedTask=true}, // IRECIST新非靶病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NewNoTargetLesion,GetStringFun=GetNewNoTargetLesionEvaluate,IsConvertedTask=true}, // IRECIST其它既往新病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.OtherNewTargetLesion,GetStringFun=GetOtherNewTargetLesionEvaluate,IsConvertedTask=true}, // IRECIST触发iRECIST后新病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.IRECISTNewTargetLesion,GetStringFun=GetNewLesionAfterTriggeringiRECSITAssessment,IsConvertedTask=true}, //IRECIST新病灶评估 new ReadingCalculateData (){QuestionType=QuestionType.NewLesionEvaluation,GetStringFun=GetNewLesionAssessment,IsConvertedTask=true}, //是否存在新病灶 new ReadingCalculateData (){QuestionType=QuestionType.NewLesions,GetStringFun=GetNewLesionEvaluate,IsConvertedTask=false}, // IRECIST是否存在新病灶 IRECIST new ReadingCalculateData (){QuestionType=QuestionType.NewLesions,GetStringFun=GetNewLesionIRECSITEvaluate,IsConvertedTask=true}, //是否存在疾病 new ReadingCalculateData (){QuestionType=QuestionType.ExistDisease,GetStringFun=GetIsExistDisease}, //整体肿瘤评估 new ReadingCalculateData (){QuestionType=QuestionType.Tumor,GetStringFun=GetTumor,IsConvertedTask=false}, // 转化时整体肿瘤评估 new ReadingCalculateData (){QuestionType=QuestionType.Tumor,GetStringFun=GetConvertingTumor,IsConvertedTask=true,IsBeTransforming=true}, //IRECIST整体肿瘤评估 new ReadingCalculateData (){QuestionType=QuestionType.Tumor,GetStringFun=GetIRECSITTargetLesionEvaluate,IsConvertedTask=true}, }; // 过滤转化的 calculateList = calculateList.Where(x => x.IsConvertedTask == inDto.IsConvertedTask||x.IsConvertedTask==null).ToList(); if (inDto.IsConvertedTask) { if (inDto.BeforeConvertedTaskId != null) { List questionTypes = calculateList.Where(x => x.IsBeTransforming).Select(x => x.QuestionType).ToList(); // 排除这几个 且不为正在转化的 calculateList = calculateList.Where(x => !(questionTypes.Contains(x.QuestionType)&& x.IsBeTransforming == false)).ToList(); } else { calculateList = calculateList.Where(x => x.IsBeTransforming == false).ToList(); } } // 没有靶病灶只计算最后几个 if (inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).Sum(x => x.TableRowInfoList.Count()) == 0) { List questionTypes = new List() { QuestionType.ISOD, QuestionType.ComparedTriggeringiSODChange, QuestionType.ComparedTriggeringSODChange, QuestionType.TargetLesion, QuestionType.NoTargetLesion, QuestionType.NewLesions, QuestionType.Tumor, QuestionType.ExistDisease, QuestionType.NewTargetLesion, QuestionType.NewNoTargetLesion, QuestionType.OtherNewTargetLesion, QuestionType.IRECISTNewTargetLesion, QuestionType.NewLesionEvaluation, }; // 没有靶病灶就删除其他几个答案的值 var isNeedDeleteTypes = calculateList.Where(x => !questionTypes.Contains(x.QuestionType)).Select(x => x.QuestionType).ToList(); var isNeedDeleteIds = inDto.QuestionInfo.Where(x =>x.QuestionType!=null&& isNeedDeleteTypes.Contains(x.QuestionType.Value)).Select(x => x.QuestionId).ToList(); await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == inDto.VisitTaskId && isNeedDeleteIds.Contains(x.ReadingQuestionTrialId), x => new ReadingTaskQuestionAnswer { Answer = string.Empty }); calculateList = calculateList.Where(x => questionTypes.Contains(x.QuestionType)).ToList(); } if (calculateType != null) { calculateList = calculateList.Where(x => calculateType.Contains(x.QuestionType)).ToList(); } var typeNAList = new List { QuestionType.SODChange, QuestionType.SODPercent, QuestionType.LowestIncrease, QuestionType.LowPercent, }; foreach (var calculate in calculateList) { var item = inDto.QuestionInfo.FirstOrDefault(x => x.QuestionType == calculate.QuestionType); if (item != null) { //计算答案 if (inDto.IsOnlyChangeAllTask == false) { #region 计算答案 if (calculate.GetDecimalFun != null) { item.Answer = (await calculate.GetDecimalFun(inDto)).ToString(); } else if (calculate.GetDecimalNullFun != null) { var value = await calculate.GetDecimalNullFun(inDto); if (value == null) { if (typeNAList.Contains(item.QuestionType ?? QuestionType.SOD)) { item.Answer = nameof(YesOrNoOrNa.NA); } else { item.Answer = this.nAString; } } else { item.Answer = value==null?"": value.Value.ToString(); } } else if (calculate.GetStringFun != null) { item.Answer = await calculate.GetStringFun(inDto); } #endregion // 修改修约小数位数 List valueOfTypes = new List() { ValueOfType.Decimals, ValueOfType.Percentage }; if (inDto.DigitPlaces != -1) { try { if (valueOfTypes.Contains(item.ValueType)) { item.Answer = decimal.Round(decimal.Parse(item.Answer ?? "0"), inDto.DigitPlaces).ToString(); } } catch (Exception) { } } needAddList.Add(new ReadingTaskQuestionAnswerDto() { Answer = item.Answer, QuestionType= calculate.QuestionType, ReadingQuestionTrialId = item.QuestionId, }); } // 修改全局 if (inDto.IsChangeOtherTask && calculate.ChangeAllTaskFun != null) { await calculate.ChangeAllTaskFun(new ChangeAllTaskDto() { calculateDto = inDto, QuestionId = item.QuestionId, }); } } } var questionIds = needAddList.Select(x => x.ReadingQuestionTrialId).ToList(); await _readingTaskQuestionAnswerRepository.BatchDeleteNoTrackingAsync(x => questionIds.Contains(x.ReadingQuestionTrialId) && x.VisitTaskId == inDto.VisitTaskId); // 这里在某些条件下 要删除 sod变化量 和isod变化量 // 靶病灶评估为IUPD或者ICPD var targetLesionIsIUorIC = needAddList.Any(x => x.QuestionType == QuestionType.TargetLesion && (x.Answer.EqEnum(TargetAssessment.iUPD) || x.Answer.EqEnum(TargetAssessment.iCPD))); // 新靶病灶为IUPD或者ICPD var newTargetLesionIsIUorIC = needAddList.Any(x => x.QuestionType == QuestionType.NewTargetLesion && (x.Answer.EqEnum(NewTargetLesionAssessment.iUPD) || x.Answer.EqEnum(NewTargetLesionAssessment.iCPD))); needAddList.ForEach(x => { if (x.QuestionType == QuestionType.ComparedTriggeringSODChange && !targetLesionIsIUorIC) { x.Answer = string.Empty; } else if (x.QuestionType == QuestionType.ComparedTriggeringiSODChange && !newTargetLesionIsIUorIC) { x.Answer = string.Empty; } x.SubjectId = inDto.SubjectId; x.ReadingQuestionCriterionTrialId = inDto.CriterionId; x.VisitTaskId = inDto.VisitTaskId; x.TrialId = inDto.TrialId; x.SubjectId = inDto.SubjectId; }); await _readingTaskQuestionAnswerRepository.AddRangeAsync(needAddList); await _readingTaskQuestionAnswerRepository.SaveChangesAsync(); #endregion } ///// ///// 获取报告整体整体评估 ///// ///// ///// //public async Task GetReportTumor(Guid visitTaskId) //{ // return await GetTumor(await _generalCalculateService.GetReadingCalculateDto(visitTaskId)); //} /// /// 获取报告是否存在疾病 /// /// /// public async Task GetReportIsExistDisease(Guid visitTaskId) { return await GetIsExistDisease(await _generalCalculateService.GetReadingCalculateDto(visitTaskId)); } /// /// 验证访视提交 /// /// /// public async Task VerifyVisitTaskQuestions(VerifyVisitTaskQuestionsInDto inDto) { if (await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.ReadingQuestionTrial.QuestionType == QuestionType.ImageQualityAssessment && x.VisitTaskId == inDto.VisitTaskId && x.Answer == ImageQualityEvaluation.Abnormal.GetEnumInt())) { return; } var tableAnswerList = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.Answer == string.Empty || x.Answer == null) && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State ) .Select(x => new { x.ReadingQuestionTrial.OrderMark, x.RowIndex, QuestionMark = x.ReadingTableQuestionTrial.QuestionMark, Answer = x.Answer, }).ToListAsync(); string errorMassage = string.Empty; var rowAnswerList = await _readingTableAnswerRowInfoRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && (x.MeasureData == string.Empty || x.MeasureData == null)) .Select(x => new { x.ReadingQuestionTrial.OrderMark, x.RowIndex, x.Id, }).ToListAsync(); var unableEvaluateRowIds = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.VisitTaskId && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State ).Where(x => (x.ReadingQuestionTrial.LesionType==LesionType.TargetLesion && x.Answer == TargetState.UnableEvaluate.GetEnumInt()) || (x.ReadingQuestionTrial.LesionType == LesionType.NewLesions && x.Answer == NewLesionState.UnableEvaluate.GetEnumInt()) || (x.ReadingQuestionTrial.LesionType == LesionType.NonTargetLesions && x.Answer == NoTargetState.UnableEvaluate.GetEnumInt()) || (x.ReadingQuestionTrial.LesionType == LesionType.NewTargetLesion && x.Answer == NewTargetLesionState.NotEvaluable.GetEnumInt()) || (x.ReadingQuestionTrial.LesionType == LesionType.NewNonTargetLesion && x.Answer == NewNoTargetLesionState.NotEvaluable.GetEnumInt()) || (x.ReadingQuestionTrial.LesionType == LesionType.OtherPreviousNewLesion && x.Answer == OtherPreviousNewLesionState.NotEvaluable.GetEnumInt()) || (x.ReadingQuestionTrial.LesionType == LesionType.TriggeringIRECSIT && x.Answer == NewLesionAfterTriggeringiRECSITState.NotEvaluable.GetEnumInt()) ) .Select(x => x.RowId).Distinct().ToListAsync(); List measureDataList = rowAnswerList.Where(x => !unableEvaluateRowIds.Contains(x.Id)).Select(x => x.OrderMark + x.RowIndex.GetLesionMark()).ToList(); List stateIsNullList = tableAnswerList.Select(x => x.OrderMark + x.RowIndex.GetLesionMark()).ToList(); List allExists = measureDataList.Intersect(stateIsNullList).ToList(); measureDataList = measureDataList.Except(allExists).ToList(); stateIsNullList = stateIsNullList.Except(allExists).ToList(); if (measureDataList.Count() > 0) { errorMassage += _localizer["ReadingCalculate_NoMarker", string.Join(',', measureDataList)] + ","; } if (tableAnswerList.Count > 0) { errorMassage += _localizer["ReadingCalculate_StatusIsEmpty", string.Join(',', stateIsNullList)] + ","; } if (allExists.Count > 0) { errorMassage += _localizer["ReadingCalculate_NoMarkerEmpty", string.Join(',', stateIsNullList)] + ","; } if (errorMassage != string.Empty) { throw new BusinessValidationFailedException(errorMassage); } } #region 将上一次的访视病灶添加到这一次 /// /// 将上一次的访视病灶添加到这一次 /// /// /// public async Task AddTaskLesionAnswerFromLastTask(AddTaskLesionAnswerFromLastTaskInDto inDto) { var visitTaskId = inDto.VisitTaskId; var taskinfo = await _visitTaskRepository.Where(x => x.Id == visitTaskId).ProjectTo(_mapper.ConfigurationProvider).FirstNotNullAsync(); var baseLineVisitId = await _subjectVisitRepository.Where(x => x.SubjectId == taskinfo.SubjectId && x.IsBaseLine).Select(x => x.Id).FirstOrDefaultAsync(); // 判断当前任务是否是基线 if (taskinfo.SourceSubjectVisitId != baseLineVisitId) { // 判断当前任务是是否有表格问题答案 if (!(await _readingTableQuestionAnswerRepository.AnyAsync(x => x.VisitTaskId == visitTaskId))) { if (taskinfo.BeforeConvertedTaskId != null) { await _generalCalculateService.AddConvertedTaskFocus(taskinfo.Id, taskinfo.BeforeConvertedTaskId.Value); } else { var LastVisitTaskId = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == taskinfo.TrialReadingCriterionId && x.IsAnalysisCreate == taskinfo.IsAnalysisCreate && x.DoctorUserId == taskinfo.DoctorUserId && x.IsSelfAnalysis == taskinfo.IsSelfAnalysis && x.SubjectId == taskinfo.SubjectId && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.ArmEnum == taskinfo.ArmEnum && x.VisitTaskNum < taskinfo.VisitTaskNum && x.TaskState == TaskState.Effect ).OrderByDescending(x => x.VisitTaskNum).Select(x => x.Id).FirstOrDefaultAsync(); var copyTableAnswers = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == LastVisitTaskId).Select(x => new CopyTableAnswerDto() { Answer = x.Answer, QuestionId = x.QuestionId, RowId = x.RowId, QuestionMark = x.ReadingTableQuestionTrial.QuestionMark, TableQuestionId = x.TableQuestionId, RowIndex = x.RowIndex, TrialId = x.TrialId }).ToListAsync(); var tableRowAnswers = await _readingTableAnswerRowInfoRepository.Where(x => x.VisitTaskId == LastVisitTaskId).ProjectTo(_mapper.ConfigurationProvider).ToListAsync(); tableRowAnswers.ForEach(x => { x.VisitTaskId = visitTaskId; x.IsCurrentTaskAdd = false; x.Id = NewId.NextGuid(); x.SeriesId = null; x.InstanceId = null; x.MeasureData = string.Empty; x.PicturePath = string.Empty; }); tableRowAnswers.ForEach(x => { x.SplitRowId = tableRowAnswers.Where(y => y.OriginalId == x.SplitRowId).Select(y => y.Id).FirstOrDefault(); x.MergeRowId = tableRowAnswers.Where(y => y.OriginalId == x.MergeRowId).Select(y => y.Id).FirstOrDefault(); }); List notNeedCopyMarks = new List() { QuestionMark.MajorAxis, QuestionMark.ShortAxis, QuestionMark.State, }; //if (taskinfo.IsConvertedTask) //{ // notNeedCopyMarks = new List() //{ // QuestionMark.MajorAxis, // QuestionMark.ShortAxis, //}; //} var tableAnswers = copyTableAnswers.Select(x => new ReadingTableQuestionAnswer { Id = NewId.NextGuid(), Answer = notNeedCopyMarks.Contains(x.QuestionMark) ? string.Empty : x.Answer, QuestionId = x.QuestionId, RowIndex = x.RowIndex, RowId = tableRowAnswers.Where(y => y.OriginalId == x.RowId).Select(x => x.Id).FirstOrDefault(), TableQuestionId = x.TableQuestionId, TrialId = x.TrialId, VisitTaskId = visitTaskId, }); var addList = _mapper.Map>(tableRowAnswers); await _readingTableAnswerRowInfoRepository.AddRangeAsync(addList); await _readingTableQuestionAnswerRepository.AddRangeAsync(tableAnswers); await _readingTableQuestionAnswerRepository.SaveChangesAsync(); } } } return new AddTaskLesionAnswerFromLastTaskOutDto() { IsBaseLine = taskinfo.SourceSubjectVisitId == baseLineVisitId, }; } #endregion #region 获取SOD /// /// 获取SOD /// /// /// 靶病灶径线之和（SOD） /// 非淋巴结的长径 和淋巴结的短径 /// /// public async Task GetSODData(ReadingCalculateDto inDto) { if (sODData != null) { return sODData.Value; } var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (tableQuestion.Count() == 0) { return null; } decimal result = 0; foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结的短径 result += (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0(); } if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.No))) { // 非淋巴结的长径 result += item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); } } sODData = result; return sODData.Value; } #endregion #region 非淋巴结靶病灶长径之和 /// /// 非淋巴结靶病灶长径之和 /// /// /// public async Task GetSumOfDiameter(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (tableQuestion.Count() == 0) { return null; } decimal result = 0; foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.No))) { // 非淋巴结的长径 result += item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); } } return result; } #endregion #region 与基线SOD相比变化量（mm） /// /// 与基线SOD相比变化量（mm） /// /// /// public async Task GetSODChange(ReadingCalculateDto inDto) { var value = await GetSODData(inDto); if (value == null || inDto.IsBaseLine) { return null; } return value.NullChange0() - await GetBaseLineSOD(inDto); } #endregion #region 与基线访视相比SOD变化百分比 /// /// 与基线访视相比SOD变化百分比 /// /// /// public async Task GetSODPercent(ReadingCalculateDto inDto) { var thisSOD = await GetSODData(inDto); if (thisSOD == null || inDto.IsBaseLine) { return null; } var baseLineSOD = await GetBaseLineSOD(inDto); if (baseLineSOD == 0) { return 100; } else { return (thisSOD.NullChange0() - baseLineSOD) * 100 / baseLineSOD; } } #endregion #region 与整个访视期间SOD最低点相比增加的值（mm） /// /// 与整个访视期间SOD最低点相比增加的值（mm） /// /// /// /// 要更新之前的 /// /// public async Task GetLowestIncrease(ReadingCalculateDto inDto) { var value = await GetSODData(inDto); if (value == null || inDto.IsBaseLine) { return null; } var decimalAnswerList = await GetLowSODVisit(inDto); var minSOD = decimalAnswerList.OrderBy(x => x.SOD).Select(x => x.SOD).FirstOrDefault(); return value.NullChange0() - minSOD; } #endregion #region 与整个访视期间SOD最低点相比增加的百分比 /// /// 与整个访视期间SOD最低点相比增加的百分比 /// /// /// /// 要更新之前的 /// /// public async Task GetLowPercent(ReadingCalculateDto inDto) { var thisSOD = await GetSODData(inDto); if (thisSOD == null || inDto.IsBaseLine) { return null; } var decimalAnswerList = await GetLowSODVisit(inDto); var minSOD = decimalAnswerList.OrderBy(x => x.SOD).Select(x => x.SOD).FirstOrDefault(); if (minSOD == 0) { return 100; } else { return (thisSOD.NullChange0() - minSOD) * 100 / minSOD; } } #endregion #region 整个访视期间SOD最低点访视名称 /// /// 整个访视期间SOD最低点访视名称 /// /// /// /// 要更新之前的 /// /// public async Task GetLowVisit(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return nameof(YesOrNoOrNa.NA); } var targetCount = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).Count(); if (targetCount == 0) { return nameof(YesOrNoOrNa.NA); } var decimalAnswerList = await GetLowSODVisit(inDto); return decimalAnswerList.OrderBy(x => x.SOD).Select(x => x.BlindName).FirstOrDefault() ?? string.Empty; } #endregion #region 是否存在非淋巴结靶病灶 /// /// 是否存在非淋巴结靶病灶 /// /// /// public async Task GetIsLymphTarget(ReadingCalculateDto inDto) { var result = IsLymph.No.GetEnumInt(); var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(IsLymph.No))) { result = IsLymph.Yes.GetEnumInt(); } } return result; } #endregion #region 是否存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上 /// /// 是否存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上 /// /// /// public async Task GetIsAddFive(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return YesOrNoOrNa.NA.GetEnumInt(); } var addFiveList = await GetIsAddFiveRowIndexs(inDto); var isExists = addFiveList.Count() > 0 ? true : false; return isExists ? YesOrNoOrNa.Yes.GetEnumInt() : YesOrNoOrNa.No.GetEnumInt(); } /// /// 获取存在淋巴结靶病灶且该病灶比上一访视短径增加5MM以上的病灶 /// /// /// public async Task> GetIsAddFiveRowIndexs(ReadingCalculateDto inDto) { List result = new List(); var LastVisitTaskId = await this.GetLastVisitTaskId(inDto); var questionIds = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).Select(x => x.QuestionId).ToList(); var lastQuestionAsnwer = await _readingTableQuestionAnswerRepository.Where(x => x.VisitTaskId == LastVisitTaskId && questionIds.Contains(x.QuestionId)).Include(x => x.ReadingQuestionTrial).Include(x => x.ReadingTableQuestionTrial).ToListAsync(); var rowIndexs = lastQuestionAsnwer.Where(x => x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes)).Select(x => x.RowIndex).Distinct().OrderBy(x => x).ToList(); var thisQuestionAsnwer = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in rowIndexs) { var lastValue = lastQuestionAsnwer.Where(x => x.RowIndex == item && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); var thisRowData = thisQuestionAsnwer.Where(x => x.RowIndex == item).SelectMany(x => x.TableQuestionList).ToList(); var thisValue = thisRowData.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); if (thisValue - lastValue >= 5) { result.Add(item); } } return result; } #endregion #region 被评估为NE的单个靶病灶 /// /// 被评估为NE的单个靶病灶 /// /// /// public async Task GetNETarget(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return ExistOrNA.NA.GetEnumInt(); } var result = inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.NE)); return result ? ExistOrNA.Exist.GetEnumInt() : ExistOrNA.NotExist.GetEnumInt(); } #endregion #region 整体肿瘤评估 /// /// 整体肿瘤评估 /// /// /// public async Task GetTumor(ReadingCalculateDto inDto) { if (inDto.IsBaseLine) { return OverallAssessment.NA.GetEnumInt(); } var targetLesion = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.TargetLesion).Select(x => x.Answer).FirstOrDefault(); var noTargetLesion = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NoTargetLesion).Select(x => x.Answer).FirstOrDefault(); var newLesions = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesions).Select(x => x.Answer).FirstOrDefault(); var result = await _tumorAssessmentRepository.Where(x => x.TargetLesion == (TargetAssessment)int.Parse(targetLesion.IsNullOrEmpty() ? TargetAssessment.NA.GetEnumInt() : targetLesion) && x.NonTargetLesions == (NoTargetAssessment)int.Parse(noTargetLesion.IsNullOrEmpty() ? NoTargetAssessment.NA.GetEnumInt() : noTargetLesion) && x.NewLesion == (NewLesionAssessment)int.Parse(newLesions.IsNullOrEmpty() ? NewLesionAssessment.NA.GetEnumInt() : newLesions)).Select(x => x.OverallEfficacy).ToListAsync(); return result.Count == 0 ? OverallAssessment.NE.GetEnumInt() : result[0].GetEnumInt(); } #endregion #region 是否存在疾病 /// /// 是否存在疾病 /// /// /// public async Task GetIsExistDisease(ReadingCalculateDto inDto) { if (!inDto.IsBaseLine) { return string.Empty; } var lesionCount = inDto.QuestionInfo.SelectMany(x => x.TableRowInfoList).Count(); return lesionCount > 0 ? ExistDisease.Yes.GetEnumInt() : ExistDisease.No.GetEnumInt(); } #endregion #region 与触发iRECIST访视相比SOD变化量 /// /// 与触发iRECIST访视相比SOD变化量 /// /// /// public async Task GetComparedTriggeringSODChange(ReadingCalculateDto inDto) { var compareTaskId = await this.GetCompareTaskId(inDto, QuestionType.TargetLesion); if (compareTaskId == null) { return string.Empty; } var lastTaskId = await GetLastVisitTaskId(inDto); // 靶病灶评估为IUPD或者ICPD var targetLesionIsIUorIC = await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.VisitTaskId == lastTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.TargetLesion && (x.Answer==TargetAssessment.iUPD.GetEnumInt()|| x.Answer==TargetAssessment.iCPD.GetEnumInt())); if (!targetLesionIsIUorIC) { return string.Empty; } var compareTaskSOD = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == compareTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.SOD).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0(); var value = await GetSODData(inDto); if (value == null || inDto.IsBaseLine|| !inDto.IsConvertedTask||inDto.BeforeConvertedTaskId!=null) { return string.Empty; } return (value.NullChange0() - compareTaskSOD).ToString(); } #endregion #region 新靶病灶直径之和（iSOD） /// /// 获取iSOD /// /// /// public async Task GetiSODData(ReadingCalculateDto inDto) { if (!inDto.IsConvertedTask) { return null; } if (iSODData != null) { return iSODData.Value; } var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewTargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (tableQuestion.Count() == 0) { return null; } decimal result = 0; foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结的短径 result += (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0(); } if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.No))) { // 非淋巴结的长径 result += item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault().IsNullOrEmptyReturn0(); } } iSODData = result; return iSODData.Value; } #endregion #region 与触发iRECIST访视相比iSOD变化量 /// /// 与触发iRECIST访视相比iSOD变化量 /// /// /// public async Task GetComparedTriggeringiSODChange(ReadingCalculateDto inDto) { var compareTaskId = await this.GetCompareTaskId(inDto, QuestionType.NewTargetLesion); if (compareTaskId == null) { return string.Empty; } var lastTaskId = await GetLastVisitTaskId(inDto); // 新靶病灶为IUPD或者ICPD var newTargetLesionIsIUorIC = await _readingTaskQuestionAnswerRepository.AnyAsync(x => x.VisitTaskId == lastTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.NewTargetLesion && (x.Answer==NewTargetLesionAssessment.iUPD.GetEnumInt() || x.Answer==NewTargetLesionAssessment.iCPD.GetEnumInt())); if (!newTargetLesionIsIUorIC) { return string.Empty; } var compareTaskiSOD = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == compareTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.ISOD).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0(); var value = await GetiSODData(inDto); if (value == null || inDto.IsBaseLine || !inDto.IsConvertedTask || inDto.BeforeConvertedTaskId != null) { return string.Empty; } return (value.NullChange0() - compareTaskiSOD).ToString(); } #endregion #region 修改其他标准 #region 修改与整个访视期间SOD最低点相比增加的值（mm） /// /// 修改与整个访视期间SOD最低点相比增加的值（mm） /// /// /// public async Task ChangeAllLowestIncrease(ChangeAllTaskDto inDto) { var visitTaskList = await GetVisitTaskAnswerList(inDto.calculateDto); var lowSod = (await GetLowSODVisit(inDto.calculateDto)).Select(x => x.SOD).OrderBy(x => x).FirstOrDefault(); foreach (var item in visitTaskList.Where(x => x.VisitTaskId != inDto.calculateDto.BaseLineTaskId)) { await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == item.VisitTaskId && x.ReadingQuestionTrialId == inDto.QuestionId, x => new ReadingTaskQuestionAnswer() { Answer = (item.SOD - lowSod).ToString() }); } } #endregion #region 修改整个访视期间SOD最低点相比增加的百分比 /// /// 修改整个访视期间SOD最低点相比增加的百分比 /// /// /// //public async Task ChangeAllLowPercent(ChangeAllTaskDto inDto) //{ // var visitTaskList = await GetVisitTaskAnswerList(inDto.calculateDto); // var lowSod = (await GetLowSODVisit(inDto.calculateDto)).Select(x => x.SOD).OrderBy(x => x).FirstOrDefault(); // foreach (var item in visitTaskList.Where(x => x.VisitTaskId != inDto.calculateDto.BaseLineTaskId)) // { // decimal percent = 0; // if (lowSod == 0) // { // percent = 100; // } // else // { // percent = decimal.Round((item.SOD - lowSod) * 100 / lowSod, 2); // } // await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => x.VisitTaskId == item.VisitTaskId && x.ReadingQuestionTrialId == inDto.QuestionId, x => new ReadingTaskQuestionAnswer() // { // Answer = percent.ToString() // }); // } //} #endregion #region 修改最低方式点名称 /// /// 修改最低方式点名称 /// /// /// public async Task ChangeAllLowVisitName(ChangeAllTaskDto inDto) { // 找到所有访视任务的Id var visitTaskIds = await _visitTaskRepository.Where(x => x.IsAnalysisCreate == inDto.IsAnalysisCreate && x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == inDto.calculateDto.TrialReadingCriterionId && x.TaskState == TaskState.Effect && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.ArmEnum == inDto.calculateDto.ArmEnum).Select(x => x.Id).ToListAsync(); var answer = (await GetLowSODVisit(inDto.calculateDto)).OrderBy(x => x.SOD).Select(x => x.BlindName).FirstOrDefault(); visitTaskIds = visitTaskIds.Where(x => x != inDto.calculateDto.BaseLineTaskId).ToList(); await this.ChangeAllVisitTaskAnswer(visitTaskIds, inDto.QuestionId, answer); } #endregion #endregion #region 通用方法 #region 修改所有访视任务的答案 /// /// 修改所有访视任务的答案 /// /// /// /// /// private async Task ChangeAllVisitTaskAnswer(List visitTaskGuids, Guid questionId, string answer) { await _readingTaskQuestionAnswerRepository.BatchUpdateNoTrackingAsync(x => visitTaskGuids.Contains(x.VisitTaskId) && x.ReadingQuestionTrialId == questionId, x => new ReadingTaskQuestionAnswer() { Answer = answer }); } #endregion #region 获取基线SOD /// /// 获取基线SOD /// /// /// private async Task GetBaseLineSOD(ReadingCalculateDto inDto) { if (await _visitTaskRepository.AnyAsync(x => x.Id == inDto.VisitTaskId && x.SourceSubjectVisit.IsBaseLine && x.IsAnalysisCreate==inDto.IsAnalysisCreate && x.ArmEnum == inDto.ArmEnum)) { return 0; } // 先找到基线的任务 var baseLineTaskId = await _visitTaskRepository.Where(x => x.SubjectId == inDto.SubjectId && x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == inDto.TrialReadingCriterionId && x.SourceSubjectVisit.IsBaseLine && x.TaskState == TaskState.Effect && x.IsAnalysisCreate == inDto.IsAnalysisCreate &&x.DoctorUserId==inDto.DoctorUserId && x.IsSelfAnalysis == inDto.IsSelfAnalysis && x.ArmEnum == inDto.ArmEnum) .Select(x => x.Id).FirstOrDefaultAsync(); var baseLineSOD = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == baseLineTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.SOD).Select(x => x.Answer).FirstOrDefaultAsync()).IsNullOrEmptyReturn0(); return baseLineSOD; } #endregion /// /// 获取最低方式 /// /// /// public async Task> GetLowSODVisit(ReadingCalculateDto inDto) { var taskAnswerList = await GetVisitTaskAnswerList(inDto); taskAnswerList = taskAnswerList.Where(x => x.VisitTaskId != inDto.VisitTaskId).ToList(); var taskIds = taskAnswerList.Select(x => x.VisitTaskId).ToList(); // 排除无法评估 var unableEvaluateTaskIds = await _readingTableQuestionAnswerRepository.Where(x => taskIds.Contains(x.VisitTaskId) && x.ReadingTableQuestionTrial.QuestionMark == QuestionMark.State && x.ReadingQuestionTrial.LesionType == LesionType.TargetLesion && x.Answer == TargetState.UnableEvaluate.GetEnumInt() ) .Select(x => x.VisitTaskId).Distinct().ToListAsync(); taskAnswerList = taskAnswerList.Where(x => !unableEvaluateTaskIds.Contains(x.VisitTaskId)).ToList(); return taskAnswerList.OrderBy(x => x.SOD).ToList(); } #region 获取访视任务信息 /// /// 获取访视任务信息 /// /// /// public async Task> GetVisitTaskAnswerList(ReadingCalculateDto inDto) { if (visitTaskAnswerList == null) { // 查询的时候要把自己排除 因为查询出来的可能不是计算出的最新的 visitTaskAnswerList = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId != inDto.VisitTaskId && x.VisitTask.ReadingCategory == ReadingCategory.Visit && x.VisitTask.IsAnalysisCreate == inDto.IsAnalysisCreate && x.VisitTask.IsSelfAnalysis == inDto.IsSelfAnalysis && x.ReadingQuestionCriterionTrialId == inDto.TrialReadingCriterionId && x.VisitTask.VisitTaskNum new VisitTaskAnswerInfo { VisitTaskId = x.VisitTaskId, QuestionId = x.ReadingQuestionTrialId, VisitName = x.VisitTask.SourceSubjectVisit.VisitName, BlindName = x.VisitTask.TaskBlindName, SOD = x.Answer.IsNullOrEmptyReturn0(), }).ToListAsync(); // 这里是需要加上自己的 基线不用管 if (visitTaskAnswerList.Count > 0) { visitTaskAnswerList.Add(new VisitTaskAnswerInfo() { VisitTaskId = inDto.VisitTaskId, BlindName=inDto.TaskBlindName, QuestionId = visitTaskAnswerList[0].QuestionId, VisitName = inDto.VisitName, SOD = (await GetSODData(inDto)).ToString().IsNullOrEmptyReturn0(), }); } } return visitTaskAnswerList; } #endregion /// /// 获取上一个访视任务Id /// /// private async Task GetLastVisitTaskId(ReadingCalculateDto inDto) { if (lastVisitTaskId != null) { return lastVisitTaskId.Value; } else { var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).ProjectTo(_mapper.ConfigurationProvider).FirstNotNullAsync(); var lastTaskId = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == taskinfo.TrialReadingCriterionId && x.IsAnalysisCreate == taskinfo.IsAnalysisCreate && x.DoctorUserId == taskinfo.DoctorUserId && x.IsSelfAnalysis == taskinfo.IsSelfAnalysis && x.SubjectId == taskinfo.SubjectId && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.ArmEnum == taskinfo.ArmEnum && x.VisitTaskNum < taskinfo.VisitTaskNum && x.TaskState == TaskState.Effect ).OrderByDescending(x => x.VisitTaskNum).Select(x => x.Id).FirstOrDefaultAsync(); lastVisitTaskId = lastTaskId; return lastTaskId; } } /// /// 获取比较任务Id 需要之前一次访视为IUPD或者ICPD /// /// private async Task GetCompareTaskId(ReadingCalculateDto inDto,QuestionType questionType) { var taskinfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).ProjectTo(_mapper.ConfigurationProvider).FirstNotNullAsync(); var lastTaskId = await GetLastVisitTaskId(inDto); if (compareTaskList == null) { // 先找到第一个转变任务的number 直接找是否为转变任务 查询耗性能 var firstChangeVisitTaskNum = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == taskinfo.TrialReadingCriterionId && x.IsAnalysisCreate == taskinfo.IsAnalysisCreate && x.DoctorUserId == taskinfo.DoctorUserId && x.IsSelfAnalysis == taskinfo.IsSelfAnalysis && x.SubjectId == taskinfo.SubjectId && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.ArmEnum == taskinfo.ArmEnum && x.BeforeConvertedTaskId != null && x.TaskState == TaskState.Effect ).OrderBy(x => x.VisitTaskNum).Select(x => x.VisitTaskNum).FirstOrDefaultAsync(); // 找到转变之后 所有任务 compareTaskList = await _visitTaskRepository.Where(x => x.ReadingCategory == ReadingCategory.Visit && x.TrialReadingCriterionId == taskinfo.TrialReadingCriterionId && x.IsAnalysisCreate == taskinfo.IsAnalysisCreate && x.DoctorUserId == taskinfo.DoctorUserId && x.IsSelfAnalysis == taskinfo.IsSelfAnalysis && x.SubjectId == taskinfo.SubjectId && x.ReadingTaskState == ReadingTaskState.HaveSigned && x.ArmEnum == taskinfo.ArmEnum && x.VisitTaskNum >= firstChangeVisitTaskNum && x.VisitTaskNum < taskinfo.VisitTaskNum && x.TaskState == TaskState.Effect ).OrderBy(x => x.VisitTaskNum).Select(x => new TirggerTaskInfo() { VisitTaskId = x.Id, VisitNum = x.VisitTaskNum, }).ToListAsync(); // 获取所有任务Id var visitTaskids = compareTaskList.Select(x => x.VisitTaskId).ToList(); // 找到所有任务的靶病灶评估和非靶病灶评估 var answers = await _readingTaskQuestionAnswerRepository.Where(x => (x.ReadingQuestionTrial.QuestionType == QuestionType.TargetLesion || x.ReadingQuestionTrial.QuestionType == QuestionType.NewTargetLesion) && visitTaskids.Contains(x.VisitTaskId) ).Select(x => new TirggerAnswerInfo() { VisitTaskId = x.VisitTaskId, Answer = x.Answer, QuestionType = x.ReadingQuestionTrial.QuestionType!.Value }).ToListAsync(); compareTaskList.ForEach(y => { y.TargetAssessmentIsIUorIC = answers.Any(x =>x.VisitTaskId==y.VisitTaskId && x.QuestionType == QuestionType.TargetLesion && (x.Answer == TargetAssessment.iUPD.GetEnumInt() || x.Answer == TargetAssessment.iCPD.GetEnumInt())); y.NewTargetLesionAssessmentIsIUorIC = answers.Any(x => x.VisitTaskId == y.VisitTaskId && x.QuestionType == QuestionType.NewTargetLesion && (x.Answer == NewTargetLesionAssessment.iUPD.GetEnumInt() || x.Answer == NewTargetLesionAssessment.iCPD.GetEnumInt())); }); } Guid? compareTaskId = null; if(compareTaskList.Count()==0) { return compareTaskId; } switch (questionType) { case QuestionType.TargetLesion: for (int i = compareTaskList.Count()-1; i>=0; i--) { if (i == 0) { return compareTaskList[0].VisitTaskId; } else { if (compareTaskList[i].TargetAssessmentIsIUorIC && !compareTaskList[i - 1].TargetAssessmentIsIUorIC) { return compareTaskList[i].VisitTaskId; } } } break; case QuestionType.NewTargetLesion: for (int i = compareTaskList.Count() - 1; i >= 0; i--) { if (i == 0) { return compareTaskList[0].VisitTaskId; } else { if (compareTaskList[i].NewTargetLesionAssessmentIsIUorIC && !compareTaskList[i - 1].NewTargetLesionAssessmentIsIUorIC) { return compareTaskList[i].VisitTaskId; } } } break; } return compareTaskId; } #endregion #region 计算阅片问题 外层问题 #region IRECIST计算 #region 获取IRECIST靶病灶评估 /// /// 获取IRECIST靶病灶评估 /// /// /// /// 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) /// { /// 靶病灶疗效为 ICPD /// } /// else if (上一访视评估为iUPD&&与触发iRECIST访视相比本次访视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 ) /// { /// 靶病灶疗效为 iUPD /// } else if (有任一靶病灶为NE状态) /// { /// 靶病灶疗效为 NE /// } /// else if (所有非淋巴结靶病灶消失，径线总和为0 mm && 所有淋巴结靶病灶的短径缩小到 < 10 mm && 非靶病灶中淋巴结病灶全部消失) /// { /// 靶病灶疗效为 iCR /// } else if (与基线期SOD相比减小≥30 %||(所有非淋巴结靶病灶消失，径线总和为0 mm && 所有淋巴结靶病灶的短径缩小到 < 10 mm&&非靶病灶中有淋巴结病灶为非消失)) /// { /// 靶病灶疗效为 iPR /// } /// else /// { /// 靶病灶疗效为 iSD /// } /// /// /// public async Task GetIRECISTTargetLesionEvaluate(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); var lastVisitTaskId = await GetLastVisitTaskId(inDto); var targetLesionQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.TargetLesion).Select(x => x.QuestionId).FirstOrDefault(); var sodQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SOD).Select(x => x.QuestionId).FirstOrDefault(); IRECISTTargetLesionDto resultData = new IRECISTTargetLesionDto() { // 基线没有靶病灶 NotExistsTargetLesion = tableQuestion.Count() == 0, // 上一访视评估 LastTaskTarget = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == targetLesionQuestionId) .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty, // 满足RECISTPD MeetRECISTPD = (await GetTargetLesionEvaluate(inDto)) == TargetAssessment.PD.GetEnumInt(), // 本次访视SOD与触发iRECIST访视相比本次访视SOD增加不小于5mm SODTiggerAddGreaterThan5 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.ComparedTriggeringSODChange).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 5, //比整体访视期间最低点SOD增加≥20 % LowSodAddGreaterThan20Percent = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 20, // 比整体访视期间最低点SOD绝对增加值≥5 mm LowSodAddGreaterThan5 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowestIncrease).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 5, // 当前访视至少有一个“存在”状态的靶病灶 HaveExistLesion = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(TargetState.Exist)), // 有任一靶病灶为NE状态 HaveNeLesion = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(TargetState.UnableEvaluate)), // 所有非淋巴结靶病灶消失，径线总和为0 AllLesionVanish = true, // 所有淋巴结靶病灶的短径缩小到 < 10 mm AllMinorAxisLessThan10 = true, // 与基线期SOD相比减小≥30 % BaseLineLessThan30 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) <= -30, //非靶病灶中淋巴结病灶全部消失 NoTargetLymphLoss = true, }; var noTargetTableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in noTargetTableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { resultData.NoTargetLymphLoss = resultData.NoTargetLymphLoss && item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.State).Select(x => x.Answer).FirstOrDefault() == NoTargetState.Loss.GetEnumInt(); } } foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结的短径 resultData.AllMinorAxisLessThan10 = resultData.AllMinorAxisLessThan10 && (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() < 10; } if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && !x.Answer.EqEnum(YesOrNoOrNa.Yes))) { resultData.AllLesionVanish = resultData.AllLesionVanish && item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.State).Select(x => x.Answer).FirstOrDefault() == TargetState.Loss.GetEnumInt(); } } TargetAssessment result = TargetAssessment.SD; // if（基线没有靶病灶） if (resultData.NotExistsTargetLesion) { // 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) else if (resultData.LastTaskTarget.EqEnum(TargetAssessment.iCPD) && resultData.MeetRECISTPD) { // 靶病灶疗效为 ICPD result = TargetAssessment.iCPD; } // else if (上一访视评估为iUPD&&与触发iRECIST访视相比本次访视SOD增加不小于5mm) else if (resultData.LastTaskTarget.EqEnum(TargetAssessment.iUPD) && resultData.SODTiggerAddGreaterThan5) { // 靶病灶疗效为 ICPD result = TargetAssessment.iCPD; } // } else if (本次访视满足RECIST1.1的PD条件 ) else if (resultData.MeetRECISTPD) { // 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) { // 靶病灶疗效为 NE result = TargetAssessment.NE; } // else if (所有非淋巴结靶病灶消失，径线总和为0 mm && 所有淋巴结靶病灶的短径缩小到 < 10 mm && 非靶病灶中淋巴结病灶全部消失) else if (resultData.AllLesionVanish&&resultData.AllMinorAxisLessThan10&& resultData.NoTargetLymphLoss) { // 靶病灶疗效为 iCR result = TargetAssessment.iCR; } // else if (与基线期SOD相比减小≥30 %||(所有非淋巴结靶病灶消失，径线总和为0 mm && 所有淋巴结靶病灶的短径缩小到 < 10 mm&&非靶病灶中有淋巴结病灶为非消失)) else if (resultData.BaseLineLessThan30||(resultData.AllLesionVanish && resultData.AllMinorAxisLessThan10 && !resultData.NoTargetLymphLoss)) { // 靶病灶疗效为 iPR result = TargetAssessment.iPR; } // else else { // 靶病灶疗效为 iSD result = TargetAssessment.iSD; } return result.GetEnumInt(); } #endregion #region IRECIST非靶病灶评估 /// /// IRECIST非靶病灶评估 /// /// /// 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) /// { /// 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 /// } /// /// /// public async Task 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) else if (data.RECISTPD) { // 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 /// /// 获取IRECIST新靶病灶评估 /// /// /// 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” && 与触发iRECIS任务iSod增加大于5mm) /// { /// 疗效为 iCPD /// } /// else if (上一访视新靶病灶评估为“iCPD”&& （当有“存在”状态的淋巴结新靶病灶||当有“存在”或“太小”状态的非淋巴结新靶病灶）) /// { /// 疗效为 iCPD /// } /// else if (当有“存在”状态的淋巴结新靶病灶||当有“存在”或“太小”状态的非淋巴结新靶病灶) /// { /// 疗效为 iUPD /// } /// else if (至少有一个新靶病无法评估) /// { /// 疗效为 NE /// } /// else ///{ /// //错误级别日志：项目、标准、受试者、阅片人、任务。输出新靶病灶数据： ///} /// /// /// public async Task GetNewTargetLesionEvaluate(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewTargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (inDto.IsBaseLine) { return TargetAssessment.NA.GetEnumInt(); } var lastVisitTaskId = await GetLastVisitTaskId(inDto); var newTargetLesionQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewTargetLesion).Select(x => x.QuestionId).FirstOrDefault(); var isodQuestionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.ISOD).Select(x => x.QuestionId).FirstOrDefault(); IRECISTNewTargetLesionDto data = new IRECISTNewTargetLesionDto() { // 不存在新靶病灶 NotExistsNewTargetLesion = tableQuestion.Count() == 0, // 所有状态为消失 AllVanish = true, // 上一访视新靶病灶评估 LastTaskNewTargetLesion = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == newTargetLesionQuestionId) .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty, //与触发iRECIS任务iSod增加大于5mm ISODAdd5mm = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.ComparedTriggeringiSODChange).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 5, //有"存在"状态的新靶病灶 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 = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.NotEvaluable)), // 当有“存在”状态的淋巴结新靶病灶 ExixtsLymphTarget = false, // 当有“存在”或“太小”状态的非淋巴结新靶病灶 ExixtsOrLessNoLymphTarget = false, }; foreach (var item in tableQuestion) { data.AllVanish = data.AllVanish && item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Loss)); data.ExixtsLymphTarget = data.ExixtsLymphTarget || ( item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Exist)) && item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes)) ); data.ExixtsOrLessNoLymphTarget = data.ExixtsOrLessNoLymphTarget || ( ( item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Exist)) || item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.TooSmall)) ) && item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && !x.Answer.EqEnum(YesOrNoOrNa.Yes)) ); } NewTargetLesionAssessment? result = NewTargetLesionAssessment.ND; // 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” && 与触发iRECIS任务iSod增加大于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”&& （当有“存在”状态的淋巴结新靶病灶||当有“存在”或“太小”状态的非淋巴结新靶病灶）) else if (data.LastTaskNewTargetLesion.EqEnum(NewTargetLesionAssessment.iCPD) &&( data.ExixtsLymphTarget || data.ExixtsOrLessNoLymphTarget)) { // 疗效为 iCPD result = NewTargetLesionAssessment.iCPD; } // else if (当有“存在”状态的淋巴结新靶病灶||当有“存在”或“太小”状态的非淋巴结新靶病灶) else if ( data.HaveExixtsState||data.ExixtsOrLessNoLymphTarget) { // 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.NE; } else { //错误级别日志：项目、标准、受试者、阅片人、任务。输出新靶病灶数据： await _generalCalculateService.LogRecord(inDto, "新靶病灶", LesionType.NewTargetLesion); } return result==null?string.Empty: result.Value.GetEnumInt(); } #endregion #region 获取新非靶病灶评估 /// /// 获取新非靶病灶评估 /// /// /// 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 /// } /// else /// { /// //错误级别日志：项目、标准、受试者、阅片人、任务。当前新非靶病灶的病灶数据输出： /// } /// /// /// public async Task 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.ND; // 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; } else { // 错误级别日志：项目、标准、受试者、阅片人、任务。当前新非靶病灶的病灶数据输出： await _generalCalculateService.LogRecord(inDto, "新非靶病灶", LesionType.NewNonTargetLesion); } return result.GetEnumInt(); } #endregion #region 其它既往新病灶评估 /// /// 获取其它既往新病灶评估 /// /// /// 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 (存在状态为“明确”的其它既往新病灶) /// { /// 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 /// } /// else /// { /// //错误级别日志：项目、标准、受试者、阅片人、任务。输出其它既往新病灶数据： /// } /// /// /// public async Task GetOtherNewTargetLesionEvaluate(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.OtherPreviousNewLesion).SelectMany(x => x.TableRowInfoList).ToList(); var lastVisitTaskId = await GetLastVisitTaskId(inDto); IRECISTOtherNewTargetLesionDto data = new IRECISTOtherNewTargetLesionDto() { // 不存在其他既往新病灶记录 NotExistsOtherNewTargetLesion = tableQuestion.Count() == 0, // 所有其他既往新病灶状态都为消失 AllVanish = tableQuestion.Count() == tableQuestion.Where(x => x.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Loss))).Count(), // 存在“明确”状态 ExistsClear = tableQuestion.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.ND; // 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 (存在状态为“明确”的其它既往新病灶) else if (data.ExistsClear) { // 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; } else { //错误级别日志：项目、标准、受试者、阅片人、任务。输出其它既往新病灶数据： await _generalCalculateService.LogRecord(inDto, "其它既往新病灶", LesionType.OtherPreviousNewLesion); } return result.GetEnumInt(); } #endregion #region 触发iRECIST后新病灶评估 /// /// /// /// /// 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 /// } /// /// /// /// public async Task 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 #region 获取新病灶评估 /// /// 获取新病灶评估 /// /// /// if(新靶病灶为ND&&新非靶病灶为ND&&其它既往新病灶为ND&&不存在触发iRECIST后新病灶） /// { /// 疗效为 ND /// } /// else if (新靶病灶为iCPD||新非靶病灶为iCPD) /// { /// 疗效为 iCPD /// } /// else if (前一访视新病灶评估为iCPD && (新靶病灶有存在病灶 || 新非靶病灶有存在状态病灶 || 其它既往新病灶有存在的病灶 || 触发iRECIST后新病灶有存在病灶)) /// { /// 疗效为 iCPD /// } /// else if (前一访视新病灶评估为iUPD && 新靶病灶上个访视评估为NE，本次访视评估为iUPD) /// { /// 疗效为 iCPD /// } /// else if (前一访视新病灶评估为iUPD && 新非靶病灶上个访视评估为NE，本次访视评估为iUPD) /// { /// 疗效为 iCPD /// } /// else if (前一访视新病灶评估为iUPD && 其它既往新病灶上个访视评估为NE或疑似，本次访视评估为iUPD) /// { /// 疗效为 iCPD /// } /// else if (前一访视新病灶评估为iUPD && 触发iRECIST后新病灶评估上个访视评估为NE或否或疑似，本次访视评估为是) /// { /// 疗效为 iCPD /// } /// else if (新靶病灶评估为iUPD || 新非靶病灶评估为iUPD || 其它既往新病灶评估为iUPD || 触发iRECIST后新病灶评估上个访视评估为是) /// { /// 疗效为 iUPD /// } /// else if (新靶病灶、新非靶病灶、其它既往新病灶,触发iRECIST后新病灶 任一项评估为NE) /// { /// 疗效为 NE /// } /// else if (其它既往新病灶或触发iRECIST后新病灶评估为“疑似”) /// { /// 疗效为 疑似 /// } /// else /// { /// //错误级别日志：项目、标准、受试者、阅片人、任务。输出新病灶数据： /// } /// /// /// public async Task GetNewLesionAssessment(ReadingCalculateDto inDto) { NewLesionAssessment? result = null; var lastVisitTaskId = await GetLastVisitTaskId(inDto); ReadingCalculateDto lastTaskCalculateDto = await _generalCalculateService.GetReadingCalculateDto(lastVisitTaskId); IRECISTNewLesionAssessmentDto data = new IRECISTNewLesionAssessmentDto() { //上一次任务的新病灶评估为iUPD LastTaskNewLesioniUPD = lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.iUPD)), //上一次任务的新病灶评估为iCPD LastTaskNewLesioniCPD = lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.iCPD)), // 存在触发iRECIST后新病灶 ExistxIRECISTNewLesion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TriggeringIRECSIT).SelectMany(x => x.TableRowInfoList).SelectMany(x=>x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && (x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Exist)||x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Equivocal))), }; // if(新靶病灶为ND&&新非靶病灶为ND&&其它既往新病灶为ND&&不存在触发iRECIST后新病灶） if(inDto.QuestionInfo.Any(x=>x.QuestionType==QuestionType.NewTargetLesion&&x.Answer.EqEnum(NewTargetLesionAssessment.ND)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewNoTargetLesion && x.Answer.EqEnum(NewNoTargetLesionAssessment.ND)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.OtherNewTargetLesion && x.Answer.EqEnum(OtherPreviousNewLesionAssessment.ND)) && !data.ExistxIRECISTNewLesion) { // 疗效为 ND result = NewLesionAssessment.ND; } // else if (新靶病灶为iCPD||新非靶病灶为iCPD) else if(inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewTargetLesion && x.Answer.EqEnum(NewTargetLesionAssessment.iCPD)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewNoTargetLesion && x.Answer.EqEnum(NewNoTargetLesionAssessment.iCPD))) { // 疗效为 iCPD result = NewLesionAssessment.iCPD; } // else if (前一访视新病灶评估为iCPD && (新靶病灶有存在病灶 || 新非靶病灶有存在状态病灶 || 其它既往新病灶有存在的病灶 || 触发iRECIST后新病灶有存在病灶)) else if(data.LastTaskNewLesioniCPD && (inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewTargetLesion).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Exist)) || inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewNonTargetLesion).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.Exist)) || inDto.QuestionInfo.Where(x => x.LesionType == LesionType.OtherPreviousNewLesion).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Exists)) || inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TriggeringIRECSIT).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Exist)) ) ) { // 疗效为 iCPD result = NewLesionAssessment.iCPD; } // else if (前一访视新病灶评估为iUPD && 新靶病灶上个访视评估为NE，本次访视评估为iUPD) else if(data.LastTaskNewLesioniUPD && lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewTargetLesion && x.Answer.EqEnum(NewTargetLesionAssessment.NE)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewTargetLesion && x.Answer.EqEnum(NewTargetLesionAssessment.iUPD)) ) { // 疗效为 iCPD result = NewLesionAssessment.iCPD; } // else if (前一访视新病灶评估为iUPD && 新非靶病灶上个访视评估为NE，本次访视评估为iUPD) else if(data.LastTaskNewLesioniUPD && lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewNoTargetLesion && x.Answer.EqEnum(NewNoTargetLesionAssessment.NE)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewNoTargetLesion && x.Answer.EqEnum(NewNoTargetLesionAssessment.iUPD)) ) { // 疗效为 iCPD result = NewLesionAssessment.iCPD; } // else if (前一访视新病灶评估为iUPD && 其它既往新病灶上个访视评估为NE或疑似，本次访视评估为iUPD) else if (data.LastTaskNewLesioniUPD && lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.OtherNewTargetLesion && (x.Answer.EqEnum(OtherPreviousNewLesionAssessment.NE)|| x.Answer.EqEnum(OtherPreviousNewLesionAssessment.Equivocal))) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.OtherNewTargetLesion && x.Answer.EqEnum(OtherPreviousNewLesionAssessment.iUPD)) ) { // 疗效为 iCPD result = NewLesionAssessment.iCPD; } // else if (前一访视新病灶评估为iUPD && 触发iRECIST后新病灶评估上个访视评估为NE或否或疑似，本次访视评估为是) else if(data.LastTaskNewLesioniUPD && lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.IRECISTNewTargetLesion && (x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.NE)|| x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.No) || x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.Equivocal))) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.IRECISTNewTargetLesion && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.Yes)) ) { // 疗效为 iCPD result = NewLesionAssessment.iCPD; } // else if (新靶病灶评估为iUPD || 新非靶病灶评估为iUPD || 其它既往新病灶评估为iUPD || 触发iRECIST后新病灶评估上个访视评估为是) else if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewTargetLesion && x.Answer.EqEnum(NewTargetLesionAssessment.iUPD)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewNoTargetLesion && x.Answer.EqEnum(NewNoTargetLesionAssessment.iUPD)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.OtherNewTargetLesion && x.Answer.EqEnum(OtherPreviousNewLesionAssessment.iUPD)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.IRECISTNewTargetLesion && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.Yes)) ) { // 疗效为 iUPD result = NewLesionAssessment.iUPD; } // else if (新靶病灶、新非靶病灶、其它既往新病灶,触发iRECIST后新病灶 任一项评估为NE) else if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewTargetLesion && x.Answer.EqEnum(NewTargetLesionAssessment.NE)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewNoTargetLesion && x.Answer.EqEnum(NewNoTargetLesionAssessment.NE)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.OtherNewTargetLesion && x.Answer.EqEnum(OtherPreviousNewLesionAssessment.NE)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.IRECISTNewTargetLesion && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.NE)) ) { // 疗效为 NE result = NewLesionAssessment.NE; } // else if (其它既往新病灶或触发iRECIST后新病灶评估为“疑似”) else if ( inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.OtherNewTargetLesion && x.Answer.EqEnum(OtherPreviousNewLesionAssessment.Equivocal)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.IRECISTNewTargetLesion && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITAssessment.Equivocal)) ) { // 疗效为 疑似 result = NewLesionAssessment.Suspected; } else { //错误级别日志：项目、标准、受试者、阅片人、任务。输出新病灶数据： // 这里是记录日志 不需要国际化 var criterionInfo = await _readingQuestionCriterionTrialRepository.Where(x => x.Id == inDto.TrialReadingCriterionId).Include(x => x.Trial).FirstNotNullAsync(); var taskInfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Include(x => x.Subject).Include(x => x.DoctorUser).FirstNotNullAsync(); StringBuilder builder = new StringBuilder(); builder.AppendLine($""); builder.AppendLine($"【项目】:【{criterionInfo.Trial.TrialCode}】"); builder.AppendLine($"【项目Id】:【{criterionInfo.TrialId}】"); builder.AppendLine($"【标准】:【{criterionInfo.CriterionName}】"); builder.AppendLine($"【标准Id】:【{criterionInfo.Id}】"); builder.AppendLine($"【受试者】:【{taskInfo.Subject.ShortName}】"); builder.AppendLine($"【受试者Id】:【{taskInfo.Subject.Id}】"); builder.AppendLine($"【阅片人】:【{taskInfo.DoctorUser.FirstName}】"); builder.AppendLine($"【阅片人Id】:【{taskInfo.DoctorUser.Id}】"); builder.AppendLine($"【任务】:【{taskInfo.TaskBlindName}】"); builder.AppendLine($"【任务Id】:【{taskInfo.Id}】"); builder.AppendLine($"【病灶类型】:【新病灶】"); builder.AppendLine($"【新靶病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewTargetLesion).Select(x=>x.Answer).FirstIsNullReturnEmpty()}】"); builder.AppendLine($"【新非靶病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewNoTargetLesion).Select(x => x.Answer).FirstIsNullReturnEmpty()}】"); builder.AppendLine($"【其它既往新病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.OtherNewTargetLesion).Select(x => x.Answer).FirstIsNullReturnEmpty()}】"); builder.AppendLine($"【触发iRECIST后新病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.IRECISTNewTargetLesion).Select(x => x.Answer).FirstIsNullReturnEmpty()}】"); _logger.LogError(builder.ToString()); } return result == null ? string.Empty : ((NewLesionAssessment)result).GetEnumInt(); } #endregion #region 获取新病灶评估 /// /// 获取新病灶评估 /// /// /// public async Task GetNewLesionIRECSITEvaluate(ReadingCalculateDto inDto) { // 逻辑改了 现在转变后全部都是NA; return NewLesionAssessment.NA.GetEnumInt(); //NewLesionAssessment result = NewLesionAssessment.No; //if (inDto.IsBaseLine) //{ // return NewLesionAssessment.NA.GetEnumInt(); //} //var newTargetQuestions = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewTargetLesion).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).ToList(); //var newNonTargetQuestions = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewNonTargetLesion).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).ToList(); //var OtherPreviousNewLesionQuestions = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.OtherPreviousNewLesion).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).ToList(); //var triggeringQuestions = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TriggeringIRECSIT).SelectMany(x => x.TableRowInfoList).SelectMany(x => x.TableQuestionList).ToList(); //// 当前访视存在至少一个明确新病灶 //if (newTargetQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.Exist)) // || newNonTargetQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.Exist)) // || OtherPreviousNewLesionQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Exists)) // || triggeringQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Exist)) // ) //{ // result = NewLesionAssessment.Yes; //} ////只要有任何一个新病灶状态为“无法评估” //else if (newTargetQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewTargetLesionState.NotEvaluable)) // || newNonTargetQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewNoTargetLesionState.NotEvaluable)) // || OtherPreviousNewLesionQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.NotEvaluable)) // || triggeringQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.NotEvaluable)) // ) //{ // result = NewLesionAssessment.NE; //} ////当前访视不存在明确新病灶且存在至少一个疑似新病灶 //else if ( (!OtherPreviousNewLesionQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Exists)) && OtherPreviousNewLesionQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(OtherPreviousNewLesionState.Equivocal))) // || (!triggeringQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Exist)) && triggeringQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionAfterTriggeringiRECSITState.Equivocal))) // ) //{ // result = NewLesionAssessment.Suspected; //} //else //{ // result = NewLesionAssessment.No; //} //return result.GetEnumInt(); } #endregion #region iRECSIT整体肿瘤评估 /// /// /// /// /// if（上一访视整体肿瘤评估评估为iCPD && 靶病灶评估、非靶病灶评估或新病灶评估任一项为iCPD或iCPD） /// { /// 疗效为 iCPD /// } /// else if (上一访视整体肿瘤评估评估为iUPD && 靶病灶评估、非靶病灶评估或新病灶评估任一项从前一访视iUPD结果评估为当前访视iCPD) /// { /// 疗效为 iCPD /// } /// else if (上一访视整体肿瘤评估评估为iUPD && 靶病灶评估、非靶病灶评估或新病灶评估任一项从前一访视非iUPD结果评估为当前访视iUPD) /// { /// 疗效为 iCPD /// } /// else if (靶病灶评估为iUPD || 非靶病灶评估为iUPD || 新病灶评估为iUPD) /// { /// 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)|| (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 /// } /// else if (靶病灶评估为iPR && 非靶病灶评估为iCR，iNN，NE或ND && 新病灶评估为ND或疑似或NE) /// { /// 疗效为 iPR /// } /// else if (靶病灶评估为iCR && 非靶病灶评估为iNN或NE && 新病灶评估为ND或疑似或NE) /// { /// 疗效为 iPR /// } /// else if (靶病灶评估为iCR && 非靶病灶评估为iCR或ND && 新病灶评估为疑似或NE) /// { /// 疗效为 iPR /// } /// else if (靶病灶评估为ND && 非靶病灶评估为iCR && 新病灶评估为疑似或NE) /// { /// 疗效为 iPR /// } /// else if (靶病灶评估为iSD && 非靶病灶评估为iCR，iNN，NE或ND && 新病灶评估为ND或疑似或NE) /// { /// 疗效为 iSD /// } /// else if (靶病灶评估为ND && 非靶病灶评估为iNN && 新病灶评估为ND或疑似或NE) /// { /// 疗效为 iNN /// } /// else if (靶病灶评估为ND && 非靶病灶评估为ND && 新病灶评估为ND或疑似) /// { /// 疗效为 ND /// } /// else if (靶病灶评估为NE && 非靶病灶评估为iCR，iNN，NE或ND && 新病灶评估为ND或疑似或NE) /// { /// 疗效为 NE /// } /// else if (靶病灶评估为ND && 非靶病灶评估为NE && 新病灶评估为ND或疑似或NE) /// { /// 疗效为 NE /// } /// else if (靶病灶评估为ND && 非靶病灶评估为ND && 新病灶评估为NE) /// { /// 疗效为 NE /// } /// else /// { /// //错误级别日志：项目、标准、受试者、阅片人、任务。输出靶病灶、非靶病灶、新病灶的评估结果： /// } /// /// /// public async Task GetIRECSITTargetLesionEvaluate(ReadingCalculateDto inDto) { var lastVisitTaskId = await GetLastVisitTaskId(inDto); ReadingCalculateDto lastTaskCalculateDto = await _generalCalculateService.GetReadingCalculateDto(lastVisitTaskId); OverallAssessment? result = null; IRECISTTargetLesionEvaluateDto data = new IRECISTTargetLesionEvaluateDto() { LastTaskLesioniUPDOriCPD = lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.Tumor && (x.Answer.EqEnum(OverallAssessment.iCPD) || x.Answer.EqEnum(OverallAssessment.iUPD))), }; // if（上一访视整体肿瘤评估评估为iCPD && 靶病灶评估、非靶病灶评估或新病灶评估任一项为iCPD或iCPD） if (lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.Tumor && x.Answer.EqEnum(OverallAssessment.iCPD)) && (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && (x.Answer.EqEnum(TargetAssessment.iCPD)||x.Answer.EqEnum(TargetAssessment.iUPD))) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && (x.Answer.EqEnum(NoTargetAssessment.iCPD) || x.Answer.EqEnum(NoTargetAssessment.iUPD))) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation&& (x.Answer.EqEnum(NewLesionAssessment.iCPD) || x.Answer.EqEnum(NewLesionAssessment.iUPD))))) { // 疗效为 iCPD result = OverallAssessment.iCPD; } // else if (上一访视整体肿瘤评估评估为iUPD&&靶病灶评估、非靶病灶评估或新病灶评估任一项从前一访视iUPD结果评估为当前访视iCPD) else if (lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.Tumor && x.Answer.EqEnum(OverallAssessment.iUPD)) && ( ( lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion &&x.Answer.EqEnum(TargetAssessment.iUPD)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iCPD)) ) || ( lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iUPD)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iCPD)) ) || ( lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.iUPD))) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.iCPD)) ) ) { // 疗效为 iCPD result = OverallAssessment.iCPD; } // else if (上一访视整体肿瘤评估评估为iUPD&&靶病灶评估、非靶病灶评估或新病灶评估任一项从前一访视非iUPD结果评估为当前访视iUPD) else if (lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.Tumor && x.Answer.EqEnum(OverallAssessment.iUPD)) && ( ( lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && !x.Answer.EqEnum(TargetAssessment.iUPD)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iUPD)) ) || ( lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && !x.Answer.EqEnum(NoTargetAssessment.iUPD)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iUPD)) ) || ( lastTaskCalculateDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && !x.Answer.EqEnum(NewLesionAssessment.iUPD))) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.iUPD)) ) ) { // 疗效为 iCPD result = OverallAssessment.iCPD; } // else if (靶病灶评估为iUPD || 非靶病灶评估为iUPD || 新病灶评估为iUPD) else if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iUPD)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.iUPD)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.iUPD))) { // 疗效为 iUPD result = OverallAssessment.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) || (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 result = OverallAssessment.iCR; } // else if (靶病灶评估为iPR && 非靶病灶评估为iCR，iNN，NE或ND && 新病灶评估为ND或疑似或NE) else if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iPR)) && (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.iNN)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.NE)) || 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)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 iPR result = OverallAssessment.iPR; } // else if (靶病灶评估为iCR && 非靶病灶评估为iNN或NE && 新病灶评估为ND或疑似或NE) 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.iNN)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.NE)) || 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)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 iPR result = OverallAssessment.iPR; } // else if (靶病灶评估为iCR && 非靶病灶评估为iCR或ND && 新病灶评估为疑似或NE) 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.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.ND)) ) && (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 iPR result = OverallAssessment.iPR; } // else if (靶病灶评估为ND && 非靶病灶评估为iCR && 新病灶评估为疑似或NE) else if (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.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 iPR result = OverallAssessment.iPR; } // else if (靶病灶评估为iSD && 非靶病灶评估为iCR，iNN，NE或ND && 新病灶评估为ND或疑似或NE) else if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.iSD)) && (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.iNN)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.NE)) || 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)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 iSD result = OverallAssessment.iSD; } // else if (靶病灶评估为ND && 非靶病灶评估为iNN && 新病灶评估为ND或疑似或NE) else if (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.iNN)) && (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 iNN result = OverallAssessment.iNN; } // else if (靶病灶评估为ND && 非靶病灶评估为ND && 新病灶评估为ND或疑似) else if (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.ND)) && (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) )) { // 疗效为 ND result = OverallAssessment.ND; } // else if (靶病灶评估为NE && 非靶病灶评估为iCR，iNN，NE或ND && 新病灶评估为ND或疑似或NE) else if (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.TargetLesion && x.Answer.EqEnum(TargetAssessment.NE)) && (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.iNN)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NoTargetLesion && x.Answer.EqEnum(NoTargetAssessment.NE)) || 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)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 NE result = OverallAssessment.NE; } // else if (靶病灶评估为ND && 非靶病灶评估为NE && 新病灶评估为ND或疑似或NE) else if (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.NE)) ) && (inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.ND)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.Suspected)) || inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) )) { // 疗效为 NE result = OverallAssessment.NE; } // else if (靶病灶评估为ND && 非靶病灶评估为ND && 新病灶评估为NE) else if (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.ND)) && inDto.QuestionInfo.Any(x => x.QuestionType == QuestionType.NewLesionEvaluation && x.Answer.EqEnum(NewLesionAssessment.NE)) ) { // 疗效为 NE result = OverallAssessment.NE; } else { //错误级别日志：项目、标准、受试者、阅片人、任务。输出靶病灶、非靶病灶、新病灶的评估结果： // 这里是记录日志 不需要国际化 var criterionInfo = await _readingQuestionCriterionTrialRepository.Where(x => x.Id == inDto.TrialReadingCriterionId).Include(x => x.Trial).FirstNotNullAsync(); var taskInfo = await _visitTaskRepository.Where(x => x.Id == inDto.VisitTaskId).Include(x => x.Subject).Include(x => x.DoctorUser).FirstNotNullAsync(); StringBuilder builder = new StringBuilder(); builder.AppendLine($""); builder.AppendLine($"【项目】:【{criterionInfo.Trial.TrialCode}】"); builder.AppendLine($"【项目Id】:【{criterionInfo.TrialId}】"); builder.AppendLine($"【标准】:【{criterionInfo.CriterionName}】"); builder.AppendLine($"【标准Id】:【{criterionInfo.Id}】"); builder.AppendLine($"【受试者】:【{taskInfo.Subject.ShortName}】"); builder.AppendLine($"【受试者Id】:【{taskInfo.Subject.Id}】"); builder.AppendLine($"【阅片人】:【{taskInfo.DoctorUser.FirstName}】"); builder.AppendLine($"【阅片人Id】:【{taskInfo.DoctorUser.Id}】"); builder.AppendLine($"【任务】:【{taskInfo.TaskBlindName}】"); builder.AppendLine($"【任务Id】:【{taskInfo.Id}】"); builder.AppendLine($"【病灶类型】:【新病灶】"); builder.AppendLine($"【靶病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.TargetLesion).Select(x => x.Answer).FirstIsNullReturnEmpty()}】"); builder.AppendLine($"【非靶病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NoTargetLesion).Select(x => x.Answer).FirstIsNullReturnEmpty()}】"); builder.AppendLine($"【新病灶评估】:【{inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.NewLesionEvaluation).Select(x => x.Answer).FirstIsNullReturnEmpty()}】"); _logger.LogError(builder.ToString()); } return result == null ? string.Empty : ((OverallAssessment)result).GetEnumInt(); } #endregion #endregion #region 转化时计算 #region 获取转化的靶病灶评估 /// /// 获取转化的靶病灶评估 /// /// /// public async Task GetConvertingTargetLesionEvaluate(ReadingCalculateDto inDto) { var beforeConvertedAnswer = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.BeforeConvertedTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.TargetLesion).Select(x => x.Answer).FirstOrDefaultAsync(); Dictionary answerConverDic = new Dictionary() { {TargetAssessment.SD.GetEnumInt(),TargetAssessment.iSD.GetEnumInt() }, {TargetAssessment.PR.GetEnumInt(),TargetAssessment.iPR.GetEnumInt() }, {TargetAssessment.PD.GetEnumInt(),TargetAssessment.iUPD.GetEnumInt() }, {TargetAssessment.CR.GetEnumInt(), TargetAssessment.iCR.GetEnumInt() }, }; try { return answerConverDic[beforeConvertedAnswer]; } catch (Exception) { return beforeConvertedAnswer==null?string.Empty: beforeConvertedAnswer; } } #endregion #region 获取转化的非靶病灶评估 /// /// 获取转化的非靶病灶评估 /// /// /// public async Task GetConvertingNoTargetLesionEvaluate(ReadingCalculateDto inDto) { var beforeConvertedAnswer = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.BeforeConvertedTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.NoTargetLesion).Select(x => x.Answer).FirstOrDefaultAsync(); Dictionary answerConverDic = new Dictionary() { {NoTargetAssessment.NN.GetEnumInt(),NoTargetAssessment.iNN.GetEnumInt() }, {NoTargetAssessment.PD.GetEnumInt(),NoTargetAssessment.iUPD.GetEnumInt() }, {NoTargetAssessment.CR.GetEnumInt(), NoTargetAssessment.iCR.GetEnumInt() }, }; try { return answerConverDic[beforeConvertedAnswer]; } catch (Exception) { return beforeConvertedAnswer == null ? string.Empty : beforeConvertedAnswer; } } #endregion #region 获取转化的整体肿瘤评估 /// /// 获取转化的整体肿瘤评估 /// /// /// public async Task GetConvertingTumor(ReadingCalculateDto inDto) { var beforeConvertedAnswer = await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == inDto.BeforeConvertedTaskId && x.ReadingQuestionTrial.QuestionType == QuestionType.Tumor).Select(x => x.Answer).FirstOrDefaultAsync(); Dictionary answerConverDic = new Dictionary() { {OverallAssessment.NN.GetEnumInt(),OverallAssessment.iNN.GetEnumInt() }, {OverallAssessment.PD.GetEnumInt(),OverallAssessment.iUPD.GetEnumInt() }, {OverallAssessment.CR.GetEnumInt(), OverallAssessment.iCR.GetEnumInt() }, {OverallAssessment.SD.GetEnumInt(), OverallAssessment.iSD.GetEnumInt() }, {OverallAssessment.PR.GetEnumInt(), OverallAssessment.iPR.GetEnumInt() }, }; try { return answerConverDic[beforeConvertedAnswer]; } catch (Exception) { return beforeConvertedAnswer == null ? string.Empty : beforeConvertedAnswer; } } #endregion #endregion #region 获取靶病灶评估 /// /// 获取靶病灶评估 /// /// /// /// 靶病灶疗效评估算法-20230306确认版本： ///if（基线没有靶病灶） ///{ /// 靶病灶疗效为 ND ///}else ///{ /// 初始化靶病灶疗效为 SD /// /// if (与基线期SOD相比减小≥30 %） /// { /// 靶病灶疗效为 PR /// /// } /// ///if (非淋巴结靶病灶长径之和 == 0 并且所有淋巴结靶病灶的短径 < 10且淋巴结非靶病灶全部消失) /// { /// 靶病灶疗效为 CR /// /// } /// ///if （有被评估为NE的单个靶病灶） /// { /// 靶病灶疗效为 NE /// /// } /// ///if (最低点SOD > 0) ///{ /// if（比整体访视期间最低点SOD增加≥20 % 且与整个访视期间最低点相比增加的值≥5 mm） /// { /// 靶病灶疗效为 PD /// /// } ///} ///else ///{ /// //进入该分支最低点SOD=0 /// if (当前访视SOD > 0 且与整个访视期间最低点相比增加的值≥5 mm) /// { /// 靶病灶疗效为PD /// /// } ///} /// ///if（上次访视点评估是CR） /// { /// if (当前访视点淋巴结病灶,至少一个淋巴结靶病灶短径≥10 mm 并且该淋巴结靶病灶短径绝对增加值≥5 mm) /// { /// 靶病灶疗效为 PD /// /// } /// if (当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径＞0 mm。) /// { /// 靶病灶疗效为 PD /// /// } ///} ///} /// /// public async Task GetTargetLesionEvaluate(ReadingCalculateDto inDto) { var tableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.TargetLesion).SelectMany(x => x.TableRowInfoList).ToList(); if (inDto.IsBaseLine) { return TargetAssessment.NA.GetEnumInt(); } TargetLesionCalculateDto resultData = new TargetLesionCalculateDto() { // 是否存在靶病灶 ExistsTargetLesion = tableQuestion.Count() > 0, // 最低SOD LowSod = (await GetLowSODVisit(inDto)).Select(x => x.SOD).FirstOrDefault(), // 当前Sod PresentSod = (await GetSODData(inDto)) ?? 0, //非淋巴结靶病灶长径之和 decimal SumOfDiameter = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SumOfDiameter).Sum(x => x.Answer.IsNullOrEmptyReturn0()), //所有淋巴结靶病灶的短径小于10mm bool DiameterLessThan10 = true, // SOD变化百分比 SODPercent = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()), // SOD 百分比与基线期SOD相比减小≥30% bool SODPercentBigger30 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) <= -30, // SOD 百分比 与基线期SOD相比减小＜30% bool SODPercentLess30 = 0 > inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) && inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.SODPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) > -30, // SOD 百分比 整体访视期间SOD最低点SOD相比增加＜20% LowSODPercentLess20 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) < 20, // SOD 百分比 比整体访视期间SOD最低点SOD增加≥20% LowSODPercentBigger20 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowPercent).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 20, // SOD 变化值 比整体访视期间SOD最低点SOD绝对增加值＜5 mm LowSODChangeLess5 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowestIncrease).Sum(x => x.Answer.IsNullOrEmptyReturn0()) < 5, // 比整体访视期间SOD最低点SOD绝对增加值≥5 mm LowSODChangeBigger5 = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.LowestIncrease).Sum(x => x.Answer.IsNullOrEmptyReturn0()) >= 5, // 被评估为NE的单个靶病灶 是否存在状态为不可评估的靶病灶 ExixtsNETargetLesion = tableQuestion.SelectMany(x => x.TableQuestionList).Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(TargetState.UnableEvaluate)), //// 上次访视点整体肿瘤评估 LastTargetLesionEvaluate = string.Empty, // 当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径＞0 mm CurrentMajoreBigger0 = false, // 当前访视点淋巴结病灶, 至少一个淋巴结靶病灶短径≥10 mm CurrenShortBigger10 = false, // 靶病灶短径增加值有5mm的Index AddFiveIndexs = await GetIsAddFiveRowIndexs(inDto), // 短径有10mm的Index ShortBigger10Indexs = new List(), //淋巴结非靶病灶状态全部为消失 NonTargetStateIsLoss = true, // 该淋巴结靶病灶短径绝对增加值≥5 mm IsAddFive = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.IsAddFive && x.Answer.EqEnum(YesOrNoOrNa.Yes)).Count() > 0, }; var nonTargetTableQuestion = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList).ToList(); foreach (var item in nonTargetTableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结非靶病灶状态全部为消失 resultData.NonTargetStateIsLoss = resultData.NonTargetStateIsLoss&& item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.State).Select(x => x.Answer).FirstOrDefault()== NoTargetState.Loss.GetEnumInt(); } } foreach (var item in tableQuestion) { if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 淋巴结的短径 resultData.DiameterLessThan10 = resultData.DiameterLessThan10&&(item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() < 10; var shortIsBigger10 = (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.ShortAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() >= 10; resultData.CurrenShortBigger10= resultData.CurrenShortBigger10|| shortIsBigger10; if (shortIsBigger10) { resultData.ShortBigger10Indexs.Add(item.RowIndex); } } if (item.TableQuestionList.Any(x => x.QuestionMark == QuestionMark.IsLymph && !x.Answer.EqEnum(YesOrNoOrNa.Yes))) { // 当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径 resultData.CurrentMajoreBigger0 = resultData.CurrentMajoreBigger0|| (item.TableQuestionList.Where(x => x.QuestionMark == QuestionMark.MajorAxis).Select(x => x.Answer).FirstOrDefault()).IsNullOrEmptyReturn0() > 0; } } var lastVisitTaskId = await GetLastVisitTaskId(inDto); var questionId = inDto.QuestionInfo.Where(x => x.QuestionType == QuestionType.Tumor).Select(x => x.QuestionId).FirstOrDefault(); resultData.LastTargetLesionEvaluate = (await _readingTaskQuestionAnswerRepository.Where(x => x.VisitTaskId == lastVisitTaskId && x.ReadingQuestionTrialId == questionId) .Select(x => x.Answer).FirstOrDefaultAsync()) ?? string.Empty; TargetAssessment result = TargetAssessment.SD; //if（基线没有靶病灶） if (!resultData.ExistsTargetLesion) { // 靶病灶疗效为 ND result = TargetAssessment.ND; } else { //初始化靶病灶疗效为 SD result = TargetAssessment.SD; //if (与基线期SOD相比减小≥30 %） if (resultData.SODPercentBigger30) { //靶病灶疗效为 PR result = TargetAssessment.PR; } //if (非淋巴结靶病灶长径之和 == 0 并且所有淋巴结靶病灶的短径 < 10且淋巴结非靶病灶全部消失) if (resultData.SumOfDiameter == 0 && resultData.DiameterLessThan10 && resultData.NonTargetStateIsLoss) { //靶病灶疗效为 CR result = TargetAssessment.CR; } // if （有被评估为NE的单个靶病灶） if (resultData.ExixtsNETargetLesion) { // 靶病灶疗效为 NE result = TargetAssessment.NE; } //if (最低点SOD > 0) if (resultData.LowSod > 0) { // if（比整体访视期间最低点SOD增加≥20 % 且与整个访视期间最低点相比增加的值≥5 mm） if (resultData.LowSODPercentBigger20 && resultData.LowSODChangeBigger5) { // 靶病灶疗效为 PD result = TargetAssessment.PD; } } else { //进入该分支最低点SOD=0 // if (当前访视SOD > 0 且与整个访视期间最低点相比增加的值≥5 mm) if (resultData.PresentSod > 0 && resultData.LowSODChangeBigger5) { // 靶病灶疗效为PD result = TargetAssessment.PD; } } //if（上次访视点评估是CR） if (resultData.LastTargetLesionEvaluate.EqEnum(OverallAssessment.CR)) { //if (当前访视点淋巴结病灶,至少一个淋巴结靶病灶短径≥10 mm 并且该淋巴结靶病灶短径绝对增加值≥5 mm) // 换句话说 就是 短径≥10 的病灶 和 短径增加值≥5的病灶 的交集数量大于0 if (resultData.ShortBigger10Indexs.Intersect(resultData.AddFiveIndexs).ToList().Count()>0) { //靶病灶疗效为 PD result = TargetAssessment.PD; } //if (当前访视点非淋巴结病灶至少一个非淋巴结靶病灶的长径＞0 mm。) if (resultData.CurrentMajoreBigger0) { //靶病灶疗效为 PD result = TargetAssessment.PD; } } #region 之前的逻辑 备注 //if (resultData.LastTargetLesionEvaluate.EqEnum(TargetAssessment.CR)) //{ // if (resultData.ExixtsNETargetLesion) // { // result = TargetAssessment.NE; // } // if (resultData.CurrenShortBigger10 && resultData.IsAddFive) // { // result = TargetAssessment.PD; // } // if (resultData.CurrentMajoreBigger0) // { // result = TargetAssessment.PD; // } //} //else //{ // if (resultData.LowSod != 0 && resultData.LowPercentBigger20 && resultData.LowChangeBigger5) // { // result = TargetAssessment.PD; // } // else // { // if (resultData.ExixtsNETargetLesion) // { // result = TargetAssessment.NE; // } // else // { // if (resultData.SODPercentBigger30) // { // if (resultData.LowPercentLess20 || resultData.LowChangeLess5) // { // result = TargetAssessment.PR; // } // if (resultData.SumOfDiameter == 0 && resultData.DiameterLessThan10 && resultData.NonTargetStateIsLoss) // { // result = TargetAssessment.CR; // } // } // } // } //} #endregion } return result.GetEnumInt(); } #endregion #region 获取非靶病灶评估 /// /// 获取非靶病灶评估 /// /// /// public async Task GetNoTargetLesionEvaluate(ReadingCalculateDto inDto) { NoTargetAssessment result = NoTargetAssessment.NN; if (inDto.IsBaseLine) { return NoTargetAssessment.NA.GetEnumInt(); } var tableRows = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NonTargetLesions).SelectMany(x => x.TableRowInfoList).ToList(); var tableQuestions = tableRows.SelectMany(x => x.TableQuestionList).ToList(); //任意单个病灶 / 病灶组评估为“显著增大” if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && (x.Answer.EqEnum(NoTargetState.Increase)|| x.Answer.EqEnum(NoTargetState.IUPD)))) { result = NoTargetAssessment.PD; } // 任意单个病灶/病灶组评估为“无法评估”并且没有“显著增大” else if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.UnableEvaluate)) && !tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Increase)) ) { result = NoTargetAssessment.NE; } // 所有单个病灶/病灶组评估为”存在”或者有些评估为“消失”有些评估为“存在”,且没有“显著增大”和“无法评估”的病灶 else if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Exist)) && !tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && (x.Answer.EqEnum(NoTargetState.Increase) || x.Answer.EqEnum(NoTargetState.UnableEvaluate))) ) { result = NoTargetAssessment.NN; } //所有单个病灶/病灶组状态评估状态为“消失” else if (tableQuestions.Count(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NoTargetState.Loss))== tableQuestions.Count(x=> x.QuestionMark == QuestionMark.State) && tableQuestions.Count(x => x.QuestionMark == QuestionMark.State)>0) { result = NoTargetAssessment.CR; } // 基线时没有非靶病灶 else if (tableQuestions.Count() == 0) { result = NoTargetAssessment.ND; } else { return string.Empty; } return result.GetEnumInt(); } #endregion #region 获取新病灶评估 /// /// 获取新病灶评估 /// /// /// public async Task GetNewLesionEvaluate(ReadingCalculateDto inDto) { NewLesionAssessment result = NewLesionAssessment.No; if (inDto.IsBaseLine) { return NewLesionAssessment.NA.GetEnumInt(); } var tableRows = inDto.QuestionInfo.Where(x => x.LesionType == LesionType.NewLesions).SelectMany(x => x.TableRowInfoList).ToList(); var tableQuestions = tableRows.SelectMany(x => x.TableQuestionList).ToList(); // 当前访视存在至少一个明确新病灶 if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.Exist))) { result = NewLesionAssessment.Yes; } //只要有任何一个新病灶状态为“无法评估” else if (tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.UnableEvaluate))) { result = NewLesionAssessment.NE; } //当前访视不存在明确新病灶且存在至少一个疑似新病灶 else if (!tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.Exist)) && tableQuestions.Any(x => x.QuestionMark == QuestionMark.State && x.Answer.EqEnum(NewLesionState.Suspected)) ) { result = NewLesionAssessment.Suspected; } else { result = NewLesionAssessment.No; } return result.GetEnumInt(); } #endregion #endregion } }