根淋巴清扫术仍然是通过淋巴系统预防肿瘤转移的基石。目前基于荧光引导手术的淋巴结切除术存在低敏感性/选择性和仅有定性信息的缺陷，影响了准确的术中决策。在此，我们开发了一个模块化的治疗诊断系统，包括NIR-II FGS和夹层式等离子体芯片（SPC）。利用术中NIR-II FGS和肿瘤阳性淋巴结检测，确定模块化治疗诊断系统在定义淋巴结转移中的可行性。在NIR-II成像窗口下，原位肿瘤和哨兵淋巴结（SLNs）能够在手术室中成功切除，没有环境光干扰。重要的是，SPC生物传感器实现了100%的肿瘤标志物敏感性和100%的特异性，并能够实现快速和高通量的术中SLN检测。我们提出了结合NIR-II FGS和合适的生物传感器的协同设计，将大大提高癌症诊断和治疗后期随访的效率。

Radical lymphadenectomy remains the cornerstone of preventing tumor metastasis through the lymphatic system. Current surgical resection of lymph nodes (LNs) based on fluorescence-guided surgery (FGS) suffers from low sensitivity/selectivity with only qualitative information, hampering accurate intraoperative decision-making. Herein, we develop a modularized theranostic system including NIR-II FGS and a sandwiched plasmonic chip (SPC). Intraoperative NIR-II FGS and detection of tumor-positive lymph nodes were performed on the gastric tumor to determine the feasibility of the modularized theranostic system in defining LN metastasis. Under the NIR-II imaging window, the orthotopic tumor and sentinel lymph nodes (SLNs) were successfully excised without ambient light interference in the operating room. Importantly, the SPC biosensor achieved 100% sensitivity and 100% specificity for tumor markers and realized rapid and high-throughput intraoperative SLN detection. We propose the synergetic design of combining the NIR-II FGS and suitable biosensor will substantially improve the efficiency of cancer diagnosis and therapy follow-up.