TED | 三分之二致死的癌症是完全可以治愈的

英语口语小镇 2018-03-20 11:10:20

没有昂贵的检测手段甚至稳定的电力,我们能够在癌细胞伤害我们之前找到癌变肿瘤么?医生,生物工程师,企业家Sangeeta Bhatia 女士领导的交叉学科实验室运用新奇的手段去研究,诊断和治愈人类疾病。她的目标是:三分之二致死的癌症是完全可以治愈的。思路清晰的她深入浅出地解释了复杂的纳米分子科学并且分享了她梦想通过简易检测挽救成千上万生命的想法。

演说者:Sangeeta Bhatia

演说题目:This tiny particle could roam your body to find tumors

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.


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.

作为一个工程师,我受到了电脑微型化的启发。作为一名医生,我想知道我们可否用 这个技术挽救更多的生命,他们都死于地球上蔓延最快的疾病之一,癌症。如今当我这样说的时候,许多人认为我说的是我们在研究治愈癌症。我们的确是。但是结果是,通过及早发现和预防癌症就会有极大的机会拯救生命。

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.


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?


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.


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.


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.


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.


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?

这只是一个关于微型化如何拯救生命的例子。作为工程师,我们认为这个就是直接微型化。你带来一个大东西并且把它变小。但是我之前提到了电脑改变了我们的生活,它们小到我们可以随身携带。那么在药物领域等效的转换会是什么样的呢?如果你有一个探测器,它小到可以在你的体内循环,自己找到肿瘤 并向外面的世界传送信号会怎样呢?

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.

这听起来有点像科幻小说。但是实际上,运用纳米技术就能实现。纳米技术可以让我们缩小探测器组成部分的尺寸,从到发丝的宽度的大小,也就是100微米 到再小1000倍的尺度。也就是100纳米。这就极大的扩展了应用范围。

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.

实际上在纳米级别尺寸的时候,材料的性质会发生改变。你拿一个常见的金属比如金,把它研磨成灰,研磨成纳米颗粒,它就会从金色外表变成红色。如果你拿一个比较稀有的材料比如硒化镉—— 会形成一块大的黑色晶体—— 如果你用这种材料做成纳米结晶,然后把它放入液体中,用光照一下,它们就会发光。

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.

它们可以发出蓝绿黄橙红不同的光,仅仅根据尺寸的不同而变化。这太疯狂了! 你可以想象宏观世界有这种材料么?这就像你衣橱里所有的棉质牛仔裤 依据尺寸不同,颜色也会不一样。

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.

作为一位医生,让我感兴趣的不仅仅是材料的颜色 在纳米尺寸会改变,它们在人体内运动的方式也将改变。这也是一种我们即将使用的观察方式,用来制造更好的癌症检测装置。

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.

下面我来解释一下。这是一条人体的血管。包裹着血管的就是肿瘤。我们将要把纳米颗粒注射进血管,并观察它们如何随着血流进入肿瘤。事实证明有许多肿瘤的血管是有漏洞的,所以纳米颗粒 可以从血流渗漏到肿瘤中。它们是否能渗透出去取决于它们的尺寸。

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.

在这张图中,较小的百纳米尺寸的 蓝色纳米颗粒正在渗漏至血管外,大一点的500纳米的红色颗粒 被困在了血管中。所以这对于工程师来说,取决于我所制造的材料的大小,我可以控制它能够去你身体里的哪一部分。

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.

在我的实验室,我们最近 研制出了一种癌症纳米检测器,小到可以进入全身血液循环并寻找肿瘤。我们设计它用于监听肿瘤的侵袭: 即肿瘤扩散所需要的化学信号。一个肿瘤冲破包围它的组织时,它需要产生一种叫做酶的化学物质来分解组织的组成结构。

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.

我们设计了这些会被酶激发的纳米颗粒。一个酶每小时 可激发一千个这种化学反应。用工程术语来描述的话,我们叫它1比1000的放大比例,这就形成了一种超级灵敏的东西。所以我们已经做了一个超灵敏的癌症检测器。

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,但我如何把这激发信号传递到外界,好方便对其进行分析呢?针对这个问题,我们将采用另一项纳米生物技术,与肾脏有关。肾脏就是一个过滤装置。它的工作是把血液中的废物过滤出来形成尿液。事实发现肾脏的过滤系统 也是依据(过滤物的)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.

所以在这个图中,你可以看到 所有小于5纳米的东西都会从血液,穿过肾,变成尿液,其他所有更大尺寸的会留下来。好,那如果我制造一个 100纳米的癌症检测装置,注射到血流中,它可以渗漏到肿瘤并被肿瘤的酶激发,释放出很小的信号,小到可以被肾脏过滤出来 并进入尿液中。我就有了一个可以在体外探测到的信号。

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.


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.

如果我们想使用一种非常灵敏先进的仪器叫做质谱仪,那我们可以让这个分子 有一个独特的质量。或者我们也许想要研制出一种 更加便宜和便于携带的分析方式。那我们就制造出可以滞留在纸上的分子,就像测孕试纸。实际上试纸的应用已经非常广泛,以至于专门形成了试纸诊断领域。

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.


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.

我将告诉你们我所希望 用我的技术会发生的,我和我的团队将不遗余力 让它变成现实。这就是: 我希望有一天 不需要昂贵的筛选设备来进行结肠镜检查,或乳房X线照片,或制作帕氏涂片,而是只需要扎一针,等一个小时,在试纸上进行一个尿检。

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.


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.

现在我知道这听起来不太现实,但是在实验室中 我们已经在老鼠体内取得了进展,它对于肺癌和卵巢癌的检测结果比现行的任何一种方法都要好。

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.

我希望这意味着有一天我们可以很快检查出 病人体内的肿瘤,不必等到十年后它们已成型,在各行各业,全球各地都是如此,这也会让更早期的治疗成为现实,我们可以比现在拯救更多的生命,只需依赖早期检测。

Thank you.(Applause)