摘要：Each year in China there are about 3.10 million new cancer cases and about 2.00 million deaths. The early screening methods to address the risk of lung cancer, breast cancer and other malignant tumors have not yet been well developed. The implementation of the strategy to over-come the cancer "early detection, early diagnosis, early treatment" was unsatisfactory, as there is not currently an early cancer screening method that is non-invasive, cheap, convenient and effec-tive. Our pre-liminary research using the serum Raman fingerprint method to screen for lung cancer and early stage breast disease compared with healthy controls,with 10 specific spectral lines demon-strated that for united principal component analysis, the (+)accuracy rate was 100%, 86%, and 91.4%;the (-) false rate was 0, 14%, 8.6%; and for united hierarchical cluster analysis the (+) accuracy rate was 81.4%,86%,and 100%, the (-) false rate was 18.6%,14%, and 0%for lung cancer,early stage breast disease,and healthy controls,respectively. We suggest that ideal usage of Raman screening for early lung cancer include:(1) the sampling of both serum and breath to further enhance the high sensitivity and specificity of the Raman fingerprinting screening method for early stage cancers. Including both serum and breath will contains all the information from small molecules that are soluble in serum or in breath produced during the process of carcinogenesis in all cells of the patient;(2) a large sample database of stageⅠlung cancer cases to establish the early stage lung cancer metabolism characteristics Raman fingerprint database,and then,expand and cre-ate databases of breast,stomach,and other cancers at early stages;and(3) an increase in the na-tional systems engineering approach to popularizing research for early cancer screening, including hardware,software,and management.%我國每年大約有310萬新發生癌癥病例,約200萬人死亡,目前還沒有找到可普及的早期癌癥篩查方法.我們在前期研究中,采用血清拉曼指紋譜篩查方法,聯合篩查肺癌(43例)和早期乳腺疾病(58例),對照健康人(35例)隊列,用10條特征譜線(636,805,945,1017,1135,1330,1399,1453,1620,1688 cm-1)處理.聯合主成份分析結果:真陽性(+)準確率分別為100%,86%,91.4%;假陰性(-)誤判率分別為接近0, 14%,8.6%;聯合聚類分析結果:真陽性(+)準確率分別為81.4%,86%,100%;假陰性(-)誤判率分別為18.6%,14%,0.我們建議,早期肺癌拉曼篩查的研究重點:①為了增強拉曼指紋譜篩查早期癌癥方法的敏感性和特異性,需要采集血清和呼氣兩種樣本,在該兩者樣品中,將包含患者的與全部癌變細胞的代謝有關的全部特征小分子的信息;②以大樣本隊列的Ⅰ期肺癌病例創建早期肺癌代謝特征拉曼指紋譜數據庫,然后,再創建早期乳腺癌、胃癌和其他癌癥的數據庫;③推進普及的早期癌癥篩查國家系統工程的研究,包括硬件、軟件和管理等建設.