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TED英語演講：2/3致死的癌癥是完全可以治愈的
演說題目：This tiny particle could roam your body to find tumors
演說者：Sangeeta Bhatia
演講稿
In the space that used to house one transistor, we can now fit one billion. That made it so that a computer the size of an entire room now fits in your pocket. You might say the future is small.
在以前，可以放置一個晶體管的空間現(xiàn)在可以放10億個。這導(dǎo)致曾經(jīng)占據(jù)了一整個房間的電腦現(xiàn)在可以放在你的口袋里。也許你會說未來東西都會越來越小。
As an engineer, I'm inspired by this miniaturization revolution in computers. As a physician, I wonder whether we could use it to reduce the number of lives lost due to one of the fastest-growing diseases on Earth:cancer. Now when I say that, what most people hear me say is that we're working on curing cancer. And we are. But it turns out that there's an incredible opportunity to save lives through the early detection and prevention of cancer.
作為一個工程師，我受到了電腦微型化的啟發(fā)。作為一名醫(yī)生，我想知道我們可否用 這個技術(shù)挽救更多的生命，他們都死于地球上蔓延最快的疾病之一，癌癥。如今當我這樣說的時候，許多人認為我說的是我們在研究治愈癌癥。我們的確是。但是結(jié)果是，通過及早發(fā)現(xiàn)和預(yù)防癌癥就會有極大的機會拯救生命。
Worldwide, over two-thirds of deaths due to cancer are fully preventable using methods that we already have in hand today. Things like vaccination, timely screening and of course, stopping smoking.
在全球，用我們今天已有的技術(shù)，超過三分之二因癌癥導(dǎo)致的死亡都是完全可以避免的。包括疫苗接種，定期篩查，當然還有，停止抽煙。
But even with the best tools and technologies that we have today, some tumors can't be detected until 10 years after they've started growing, when they are 50 million cancer cells strong. What if we had better technologies to detect some of these more deadly cancers sooner, when they could be removed, when they were just getting started?
但是就算使用如今我們擁有的最先進的工具和手段，一些腫瘤仍然無法被探測到，直到它們已經(jīng)生長了十年才被發(fā)現(xiàn)，這時已經(jīng)積累了5000萬的癌細胞了。要是我們有更好的技術(shù)在癌細胞剛剛產(chǎn)生時，在還可以被鏟除時就能更快監(jiān)測到一些更為致命的癌癥，會怎么樣呢?
Let me tell you about how miniaturization might get us there. This is a microscope in a typical lab that a pathologist would use for looking at a tissue specimen, like a biopsy or a pap smear. This $7,000 microscopewould be used by somebody with years of specialized training to spot cancer cells. This is an image from a colleague of mine at Rice University, Rebecca Richards-Kortum.
讓我來告訴你們微型技術(shù)如何可能讓我們?nèi)缭浮＿@是一個普通實驗室中的顯微鏡，病理學(xué)家用它觀察組織標本，就像活體切片或巴氏涂片。這個7000美元的顯微鏡可以被受過幾年專業(yè)訓(xùn)練的人用來檢測癌細胞。這張圖片來自于我萊斯大學(xué)的同事，麗貝卡·理查茲科圖姆。
What she and her team have done is miniaturize that whole microscope into this $10 part, and it fits on the end of an optical fiber. Now what that means is instead of taking a sample from a patient and sending it to the microscope, you can bring the microscope to the patient. And then, instead of requiring a specialist to look at the images, you can train the computer to score normal versus cancerous cells.
她和她的團隊實現(xiàn)了微縮這整個顯微鏡到這個價值10美金的部件中，可以把它安裝在光纖的一端。這意味著無需在患者身上取得一個樣本，并送到顯微鏡下檢查，你可以直接就把顯微鏡帶入病人體內(nèi)。并且，不用要求一個專業(yè)領(lǐng)域的人來觀察這個圖像，你直接可以訓(xùn)練電腦去比對正常和癌變的細胞。
Now this is important, because what they found working in rural communities, is that even when they have a mobile screening van that can go out into the community and perform exams and collect samples and send them to the central hospital for analysis, that days later, women get a call with an abnormal test result and they're asked to come in.
這一點很重要，因為他們發(fā)現(xiàn)在農(nóng)村地區(qū)工作，就算他們有移動的檢查車，可以走進農(nóng)村進行檢查并且收集樣本，傳輸樣本到中心醫(yī)院進行分析，幾天之后，女性們接到一個異常測試結(jié)果的電話，并被要求來醫(yī)院。
Fully half of them don't turn up because they can't afford the trip. With the integrated microscope and computer analysis, Rebecca and her colleagues have been able to create a vanthat has both a diagnostic setup and a treatment setup. And what that means is that they can do a diagnosisand perform therapy on the spot, so no one is lost to follow up.
有一半的人不會出現(xiàn)，因為她們無法支付路費。有了集成顯微鏡和計算機分析技術(shù)，麗貝卡和她的同事研發(fā)了同時具有診斷裝置和治療裝置的醫(yī)療車。這意味著他們可以集診斷和實施治療于一車，每個病人都不會錯過跟蹤治療。
That's just one example of how miniaturization can save lives. Now as engineers, we think of this as straight-up miniaturization. You took a big thing and you made it little. But what I told you before about computers was that they transformed our lives when they became small enough for us to take them everywhere. So what is the transformational equivalent like that in medicine?
這只是一個關(guān)于微型化如何拯救生命的例子。作為工程師，我們認為這個就是直接微型化。你帶來一個大東西并且把它變小。但是我之前提到了電腦改變了我們的生活，它們小到我們可以隨身攜帶。那么在藥物領(lǐng)域等效的轉(zhuǎn)換會是什么樣的呢?如果你有一個探測器，它小到可以在你的體內(nèi)循環(huán)，自己找到腫瘤 并向外面的世界傳送信號會怎樣呢?
Well, what if you had a detector that was so small that it could circulate in your body, find the tumor all by itself and send a signal to the outside world? It sounds a little bit like science fiction. But actually, nanotechnology allows us to do just that. Nanotechnology allows us to shrink the parts that make up the detector from the width of a human hair,which is 100 microns, to a thousand times smaller, which is 100 nanometers. And that has profound implications.
這聽起來有點像科幻小說。但是實際上，運用納米技術(shù)就能實現(xiàn)。納米技術(shù)可以讓我們縮小探測器組成部分的尺寸，從到發(fā)絲的寬度的大小，也就是100微米 到再小1000倍的尺度。也就是100納米。這就極大的擴展了應(yīng)用范圍。
It turns out that materials actually change their properties at the nanoscale. You take a common material like gold, and you grind it into dust, into gold nanoparticles, and it changes from looking gold to looking red. If you take a more exotic material like cadmium selenide -- forms a big, black crystal -- if you make nanocrystals out of this material and you put it in a liquid, and you shine light on it, they glow.
實際上在納米級別尺寸的時候，材料的性質(zhì)會發(fā)生改變。你拿一個常見的金屬比如金，把它研磨成灰，研磨成納米顆粒，它就會從金色外表變成紅色。如果你拿一個比較稀有的材料比如硒化鎘—— 會形成一塊大的黑色晶體—— 如果你用這種材料做成納米結(jié)晶，然后把它放入液體中，用光照一下，它們就會發(fā)光。
And they glow blue, green, yellow, orange, red, depending only on their size. It's wild! Can you imagine an object like that in the macro world? It would be like all the denim jeans in your closet are all made of cotton, but they are different colors depending only on their size.
它們可以發(fā)出藍綠黃橙紅不同的光，僅僅根據(jù)尺寸的不同而變化。這太瘋狂了! 你可以想象宏觀世界有這種材料么?這就像你衣櫥里所有的棉質(zhì)牛仔褲 依據(jù)尺寸不同，顏色也會不一樣。
So as a physician, what's just as interesting to me is that it's not just the color of materials that changes at the nanoscale; the way they travel in your body also changes. And this is the kind of observation that we're going to use to make a better cancer detector.
作為一位醫(yī)生，讓我感興趣的不僅僅是材料的顏色 在納米尺寸會改變，它們在人體內(nèi)運動的方式也將改變。這也是一種我們即將使用的觀察方式，用來制造更好的癌癥檢測裝置。
So let me show you what I mean. This is a blood vessel in the body. Surrounding the blood vessel is a tumor.We're going to inject nanoparticles into the blood vessel and watch how they travel from the bloodstream into the tumor. Now it turns out that the blood vessels of many tumors are leaky, and so nanoparticles can leak out from the bloodstream into the tumor. Whether they leak out depends on their size.
下面我來解釋一下。這是一條人體的血管。包裹著血管的就是腫瘤。我們將要把納米顆粒注射進血管，并觀察它們?nèi)绾坞S著血流進入腫瘤。事實證明有許多腫瘤的血管是有漏洞的，所以納米顆粒 可以從血流滲漏到腫瘤中。它們是否能滲透出去取決于它們的尺寸。
So in this image,the smaller, hundred-nanometer, blue nanoparticles are leaking out, and the larger, 500-nanometer, red nanoparticles are stuck in the bloodstream. So that means as an engineer, depending on how big or small I make a material, I can change where it goes in your body.
在這張圖中，較小的百納米尺寸的 藍色納米顆粒正在滲漏至血管外，大一點的500納米的紅色顆粒 被困在了血管中。所以這對于工程師來說，取決于我所制造的材料的大小，我可以控制它能夠去你身體里的哪一部分。
In my lab, we recently made a cancer nanodetector that is so small that it could travel into the body and look for tumors. We designed it to listen for tumor invasion: the orchestra of chemical signals that tumors need to make to spread. For a tumor to break out of the tissue that it's born in, it has to make chemicals called enzymes to chew through the scaffolding of tissues.
在我的實驗室，我們最近 研制出了一種癌癥納米檢測器，小到可以進入全身血液循環(huán)并尋找腫瘤。我們設(shè)計它用于監(jiān)聽腫瘤的侵襲： 即腫瘤擴散所需要的化學(xué)信號。一個腫瘤沖破包圍它的組織時，它需要產(chǎn)生一種叫做酶的化學(xué)物質(zhì)來分解組織的組成結(jié)構(gòu)。
We designed these nanoparticles to be activated by these enzymes. One enzyme can activate a thousand of these chemical reactions in an hour. Now in engineering, we call that one-to-a-thousand ratio a form of amplification, and it makes something ultrasensitive. So we've made an ultrasensitive cancer detector.
我們設(shè)計了這些會被酶激發(fā)的納米顆粒。一個酶每小時 可激發(fā)一千個這種化學(xué)反應(yīng)。用工程術(shù)語來描述的話，我們叫它1比1000的放大比例，這就形成了一種超級靈敏的東西。所以我們已經(jīng)做了一個超靈敏的癌癥檢測器。
OK, but how do I get this activated signal to the outside world, where I can act on it? For this, we're going to use one more piece of nanoscale biology, and that has to do with the kidney. The kidney is a filter. Its job is to filter out the blood and put waste into the urine. It turns out that what the kidney filters is also dependent on size.
好的，但我如何把這激發(fā)信號傳遞到外界，好方便對其進行分析呢?針對這個問題，我們將采用另一項納米生物技術(shù)，與腎臟有關(guān)。腎臟就是一個過濾裝置。它的工作是把血液中的廢物過濾出來形成尿液。事實發(fā)現(xiàn)腎臟的過濾系統(tǒng) 也是依據(jù)(過濾物的)大小。
So in this image, what you can see is that everything smaller than five nanometers is going from the blood, through the kidney, into the urine, and everything else that's bigger is retained. OK, so if I make a 100-nanometer cancer detector, I inject it in the bloodstream, it can leak into the tumor where it's activated by tumor enzymes to release a small signal that is small enough to be filtered out of the kidney and put into the urine, I have a signal in the outside world that I can detect.
所以在這個圖中，你可以看到 所有小于5納米的東西都會從血液，穿過腎，變成尿液，其他所有更大尺寸的會留下來。好，那如果我制造一個 100納米的癌癥檢測裝置，注射到血流中，它可以滲漏到腫瘤并被腫瘤的酶激發(fā)，釋放出很小的信號，小到可以被腎臟過濾出來 并進入尿液中。我就有了一個可以在體外探測到的信號。
OK, but there's one more problem. This is a tiny little signal, so how do I detect it? Well, the signal is just a molecule. They're molecules that we designed as engineers. They're completely synthetic, and we can design them so they are compatible with our tool of choice.
好，但是還有另一個問題。這是個小而微弱的信號，我怎么來檢測它?實際上，信號就是一個分子。它們是我們作為工程師設(shè)計的分子。它們完全人工合成并且我們可以設(shè)計它們，所以它們和我們選用的工具相匹配。
If we want to use a really sensitive, fancy instrument called a mass spectrometer, then we make a molecule with a unique mass. Or maybe we want make something that's more inexpensive and portable. Then we make molecules that we can trap on paper,like a pregnancy test. In fact, there's a whole world of paper tests that are becoming available in a field called paper diagnostics.
如果我們想使用一種非常靈敏先進的儀器叫做質(zhì)譜儀，那我們可以讓這個分子 有一個獨特的質(zhì)量�；蛘呶覀円苍S想要研制出一種 更加便宜和便于攜帶的分析方式。那我們就制造出可以滯留在紙上的分子，就像測孕試紙。實際上試紙的應(yīng)用已經(jīng)非常廣泛，以至于專門形成了試紙診斷領(lǐng)域。
Alright, where are we going with this? What I'm going to tell you next, as a lifelong researcher, represents a dream of mine. I can't say that's it's a promise; it's a dream. But I think we all have to have dreams to keep us pushing forward, even -- and maybe especially -- cancer researchers.
那好，我們現(xiàn)在進展如何呢?我接下來要告訴你們的，作為一個終身的研究人員，代表了我的一個夢想。我不敢說那是一個諾言;這是一個夢想。但是我想我們都應(yīng)該有夢想來鞭策我們前行，甚至——并且可能尤其是針對癌癥的研究者。
I'm going to tell you what I hope will happen with my technology, that my team and I will put our hearts and souls into making a reality. OK, here goes. I dream that one day, instead of going into an expensive screening facility to get a colonoscopy, or a mammogram, or a pap smear, that you could get a shot, wait an hour, and do a urine test on a paper strip.
我將告訴你們我所希望 用我的技術(shù)會發(fā)生的，我和我的團隊將不遺余力 讓它變成現(xiàn)實。這就是： 我希望有一天 不需要昂貴的篩選設(shè)備來進行結(jié)腸鏡檢查，或乳房X線照片，或制作帕氏涂片，而是只需要扎一針，等一個小時，在試紙上進行一個尿檢。
I imagine that this could even happen without the need for steady electricity,or a medical professional in the room. Maybe they could be far away and connected only by the image on a smartphone.
我期待甚至可以不需要穩(wěn)定的電力供應(yīng)，或者一位醫(yī)務(wù)工作者呆在診室。也許他們在很遠的地方，只通過智能手機上的圖像進行聯(lián)系。
Now I know this sounds like a dream, but in the lab we already have this working in mice, where it works better than existing methods for the detection of lung, colon and ovarian cancer.
現(xiàn)在我知道這聽起來不太現(xiàn)實，但是在實驗室中 我們已經(jīng)在老鼠體內(nèi)取得了進展，它對于肺癌和卵巢癌的檢測結(jié)果比現(xiàn)行的任何一種方法都要好。
And I hope that what this means is that one day we can detect tumors in patients sooner than 10 years after they've started growing,in all walks of life, all around the globe, and that this would lead to earlier treatments, and that we could save more lives than we can today, with early detection.
我希望這意味著有一天我們可以很快檢查出 病人體內(nèi)的腫瘤，不必等到十年后它們已成型，在各行各業(yè)，全球各地都是如此，這也會讓更早期的治療成為現(xiàn)實，我們可以比現(xiàn)在拯救更多的生命，只需依賴早期檢測。
Thank you.(Applause)
謝謝。(掌聲)
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