Accurate identification of cancer from inflammation and normal tissue in a rapid, sensitive, and quantitative fashion is important for cancer diagnosis and resection during surgery. Here we report the use of cyclooxygenase-2 as a marker for identification of cancer from inflammation and the design of a novel smart COX-2-specific fluorogenic probe (NANQ-IMC6). The probe's fluorescence is "turned on" in both inflammations and cancers where COX-2 is overexpressed. Intriguingly, the fluorescent emission is quite different at these two sites with different expression level of COX-2. Hence, NANQ-IMC6 can not only distinguish normal cells/tissues from cancer cells/tissues but also distinguish the latter from sites of inflammation lesions by the different fluorescence recognition of NANQ-IMC6 for COX-2 enzymes. Following spraying with the NANQ-IMC6 solution, cancerous tissue, inflamed tissues, and normal tissues can be accurately discriminated in vivo by the unaided eye using a hand-held ultraviolet lamp emitting at 365 nm. So the probe may have potential application varying from cancer inflammation diagnosis to guiding tumor resection during surgery.