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.%我国每年大约有310万新发生癌症病例,约200万人死亡,目前还没有找到可普及的早期癌症筛查方法.我们在前期研究中,采用血清拉曼指纹谱筛查方法,联合筛查肺癌(43例)和早期乳腺疾病(58例),对照健康人(35例)队列,用10条特征谱线(636,805,945,1017,1135,1330,1399,1453,1620,1688 cm-1)处理.联合主成份分析结果:真阳性(+)准确率分别为100%,86%,91.4%;假阴性(-)误判率分别为接近0, 14%,8.6%;联合聚类分析结果:真阳性(+)准确率分别为81.4%,86%,100%;假阴性(-)误判率分别为18.6%,14%,0.我们建议,早期肺癌拉曼筛查的研究重点:①为了增強拉曼指纹谱筛查早期癌症方法的敏感性和特异性,需要采集血清和呼气两种样本,在该两者样品中,将包含患者的与全部癌变细胞的代谢有关的全部特征小分子的信息;②以大样本队列的Ⅰ期肺癌病例创建早期肺癌代谢特征拉曼指纹谱数据库,然后,再创建早期乳腺癌、胃癌和其他癌症的数据库;③推进普及的早期癌症筛查国家系统工程的研究,包括硬件、软件和管理等建设.
