Advanced integrated SERS-based strategies for the early diagnosis of upper gastrointestinal cancers

Upper gastrointestinal (UGI) cancers are associated with high incidence and poor prognosis due to their insidious onset, posing a serious threat to human health. Traditional diagnostic approaches, including endoscopic biopsy, imaging modalities, and molecular assays, frequently suffer from tedious procedures and insufficient sensitivity. Therefore, it is imperative to develop novel technologies for the early diagnosis of UGI cancers to reduce diagnostic delay, ensure diagnostic accuracy, and ultimately improve patient survival rates. Owing to its exceptional sensitivity and rich molecular fingerprinting information, surface-enhanced Raman spectroscopy (SERS) has emerged as an invaluable analytical tool for uncovering metabolic molecular alterations, thereby facilitating rapid, sensitive, and early-stage diagnosis of UGI cancers. Herein, this review not only outlines the principles and detection strategies of SERS technology, but also highlights its recent advances in the early diagnosis of UGI cancers, particularly in conjunction with other innovative technologies. Ultimately, the current challenges and future development directions are discussed, providing a valuable perspective to guide future efforts toward early UGI cancer screening.