This tiny particle could roam your body to find tumors | Sangeeta Bhatia

翻译人员: Gu Yu 校对人员: Li Jiaying

In the space that used to house one transistor,

在以前，可以放置一个晶体管的空间

we can now fit one billion.

现在可以放10亿个。

That made it so that a computer the size of an entire room

这导致曾经占据了一整个房间的电脑

now fits in your pocket.

现在可以放在你的口袋里。

You might say the future is small.

也许你会说 未来东西都会越来越小。

As an engineer,

作为一个工程师，

I'm inspired by this miniaturization revolution in computers.

我受到了电脑微型化的启发。

As a physician,

作为一名医生，

I wonder whether we could use it to reduce the number of lives lost

我想知道我们可否用 这个技术挽救更多的生命，

due to one of the fastest-growing diseases on Earth:

他们都死于地球上蔓延最快的疾病之一，

cancer.

癌症。

Now when I say that,

如今当我这样说的时候，

what most people hear me say is that we're working on curing cancer.

许多人认为我说的是我们在研究治愈癌症。

And we are.

我们的确是。

But it turns out

但是结果是，

通过及早发现和预防癌症

that there's an incredible opportunity to save lives

through the early detection and prevention of cancer.

就会有极大的机会拯救生命。

Worldwide, over two-thirds of deaths due to cancer are fully preventable

在全球，用我们今天已有的技术， 超过三分之二因癌症导致的死亡

using methods that we already have in hand today.

都是完全可以避免的。

Things like vaccination, timely screening

包括疫苗接种，定期筛查，

and of course, stopping smoking.

当然还有，停止抽烟。

But even with the best tools and technologies that we have today,

但是就算使用如今我们拥有的 最先进的工具和手段，

some tumors can't be detected

一些肿瘤仍然无法被探测到，

直到它们已经生长了十年才被发现，

until 10 years after they've started growing,

when they are 50 million cancer cells strong.

这时已经积累了5000万的癌细胞了。

What if we had better technologies

要是我们有更好的技术

to detect some of these more deadly cancers sooner,

在癌细胞刚刚产生时， 在还可以被铲除时就能更快

监测到一些更为致命的癌症，

when they could be removed,

when they were just getting started?

会怎么样呢？

Let me tell you about how miniaturization might get us there.

让我来告诉你们微型技术 如何可能让我们如愿。

This is a microscope in a typical lab

这是一个普通实验室中的显微镜，

that a pathologist would use for looking at a tissue specimen,

病理学家用它观察组织标本，

就像活体切片或巴氏涂片。

like a biopsy or a pap smear.

This $7,000 microscope

这个7000美元的显微镜

可以被受过几年专业训练的人

would be used by somebody with years of specialized training

to spot cancer cells.

用来检测癌细胞。

This is an image from a colleague of mine at Rice University,

这张图片来自于我莱斯大学的同事，

Rebecca Richards-Kortum.

丽贝卡·理查兹科图姆。

What she and her team have done is miniaturize that whole microscope

她和她的团队实现了微缩这整个显微镜

into this $10 part,

到这个价值10美金的部件中，

and it fits on the end of an optical fiber.

可以把它安装在光纤的一端。

Now what that means is instead of taking a sample from a patient

这意味着无需在患者身上取得一个样本，

and sending it to the microscope,

并送到显微镜下检查，

you can bring the microscope to the patient.

你可以直接就把显微镜带入病人体内。

And then, instead of requiring a specialist to look at the images,

并且，不用要求一个专业领域的人 来观察这个图像，

you can train the computer to score normal versus cancerous cells.

你直接可以训练电脑去比对 正常和癌变的细胞。

Now this is important,

这一点很重要，

because what they found working in rural communities,

因为他们发现在农村地区工作，

is that even when they have a mobile screening van

就算他们有移动的检查车，

that can go out into the community and perform exams

可以走进农村进行检查

and collect samples

并且收集样本，

and send them to the central hospital for analysis,

传输样本到中心医院进行分析，

that days later,

几天之后，

women get a call with an abnormal test result

女性们接到一个异常测试结果的电话，

and they're asked to come in.

并被要求来医院。

Fully half of them don't turn up because they can't afford the trip.

有一半的人不会出现， 因为她们无法支付路费。

With the integrated microscope and computer analysis,

有了集成显微镜和计算机分析技术，

Rebecca and her colleagues have been able to create a van

丽贝卡和她的同事研发了 同时具有

诊断装置和治疗装置的医疗车。

that has both a diagnostic setup and a treatment setup.

And what that means is that they can do a diagnosis

这意味着他们可以集诊断

and perform therapy on the spot,

和实施治疗于一车，

so no one is lost to follow up.

每个病人都不会错过跟踪治疗。

That's just one example of how miniaturization can save lives.

这只是一个关于微型化 如何拯救生命的例子。

Now as engineers,

作为工程师，

we think of this as straight-up miniaturization.

我们认为这个就是直接微型化。

You took a big thing and you made it little.

你带来一个大东西并且把它变小。

But what I told you before about computers

但是我之前提到了电脑

was that they transformed our lives

改变了我们的生活，

when they became small enough for us to take them everywhere.

它们小到我们可以随身携带。

So what is the transformational equivalent like that in medicine?

那么在药物领域 等效的转换会是什么样的呢？

Well, what if you had a detector

如果你有一个探测器，

that was so small that it could circulate in your body,

它小到可以在你的体内循环，

find the tumor all by itself

自己找到肿瘤

and send a signal to the outside world?

并向外面的世界传送信号会怎样呢？

It sounds a little bit like science fiction.

这听起来有点像科幻小说。

But actually, nanotechnology allows us to do just that.

但是实际上，运用纳米技术就能实现。

Nanotechnology allows us to shrink the parts that make up the detector

纳米技术可以让我们缩小 探测器组成部分的尺寸，

from the width of a human hair,

从到发丝的宽度的大小，

which is 100 microns,

也就是100微米

to a thousand times smaller,

到再小1000倍的尺度。

which is 100 nanometers.

也就是100纳米。

And that has profound implications.

这就极大的扩展了应用范围。

It turns out that materials actually change their properties

实际上在纳米级别尺寸的时候，

at the nanoscale.

材料的性质会发生改变。

You take a common material like gold,

你拿一个常见的金属比如金，

and you grind it into dust, into gold nanoparticles,

把它研磨成灰，研磨成纳米颗粒，

and it changes from looking gold to looking red.

它就会从金色外表变成红色。

If you take a more exotic material like cadmium selenide --

如果你拿一个比较稀有的 材料比如硒化镉——

forms a big, black crystal --

会形成一块大的黑色晶体——

if you make nanocrystals out of this material

如果你用这种材料做成纳米结晶，

and you put it in a liquid,

然后把它放入液体中，

and you shine light on it,

用光照一下，

they glow.

它们就会发光。

And they glow blue, green, yellow, orange, red,

它们可以发出 蓝绿黄橙红不同的光，

depending only on their size.

仅仅根据尺寸的不同而变化。

It's wild! Can you imagine an object like that in the macro world?

这太疯狂了！ 你可以想象宏观世界有这种材料么？

It would be like all the denim jeans in your closet are all made of cotton,

这就像你衣橱里所有的棉质牛仔裤

but they are different colors depending only on their size.

依据尺寸不同，颜色也会不一样。

(Laughter)

（笑声）

So as a physician,

作为一位医生，

what's just as interesting to me

让我感兴趣的

is that it's not just the color of materials

不仅仅是材料的颜色

that changes at the nanoscale;

在纳米尺寸会改变，

the way they travel in your body also changes.

它们在人体内运动的方式也将改变。

And this is the kind of observation that we're going to use

这也是一种我们即将使用的观察方式，

to make a better cancer detector.

用来制造更好的癌症检测装置。

So let me show you what I mean.

下面我来解释一下。

This is a blood vessel in the body.

这是一条人体的血管。

Surrounding the blood vessel is a tumor.

包裹着血管的就是肿瘤。

We're going to inject nanoparticles into the blood vessel

我们将要把纳米颗粒注射进血管，

and watch how they travel from the bloodstream into the tumor.

并观察它们如何随着血流进入肿瘤。

Now it turns out that the blood vessels of many tumors are leaky,

事实证明有许多肿瘤的血管是有漏洞的,

and so nanoparticles can leak out from the bloodstream into the tumor.

所以纳米颗粒 可以从血流渗漏到肿瘤中。

Whether they leak out depends on their size.

它们是否能渗透出去取决于它们的尺寸。

So in this image,

在这张图中，

the smaller, hundred-nanometer, blue nanoparticles are leaking out,

较小的百纳米尺寸的 蓝色纳米颗粒正在渗漏至血管外，

and the larger, 500-nanometer, red nanoparticles

大一点的500纳米的红色颗粒

are stuck in the bloodstream.

被困在了血管中。

So that means as an engineer,

所以这对于工程师来说，

depending on how big or small I make a material,

取决于我所制造的材料的大小，

I can change where it goes in your body.

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

在我的实验室，我们最近 研制出了一种癌症纳米检测器，

that is so small that it could travel into the body and look for tumors.

小到可以进入全身血液循环并寻找肿瘤。

We designed it to listen for tumor invasion:

我们设计它用于监听肿瘤的侵袭：

the orchestra of chemical signals that tumors need to make to spread.

即肿瘤扩散所需要的化学信号。

For a tumor to break out of the tissue that it's born in,

一个肿瘤冲破包围它的组织时，

it has to make chemicals called enzymes

它需要产生一种叫做酶的化学物质

to chew through the scaffolding of tissues.

来分解组织的组成结构。

We designed these nanoparticles to be activated by these enzymes.

我们设计了这些会被酶激发的纳米颗粒。

One enzyme can activate a thousand of these chemical reactions in an hour.

一个酶每小时 可激发一千个这种化学反应。

Now in engineering, we call that one-to-a-thousand ratio

用工程术语来描述的话， 我们叫它1比1000的

a form of amplification,

放大比例，

and it makes something ultrasensitive.

这就形成了一种超级灵敏的东西。

So we've made an ultrasensitive cancer detector.

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,

好的，但我如何把这激发信号传递到外界，

where I can act on it?

好方便对其进行分析呢？

For this, we're going to use one more piece of nanoscale biology,

针对这个问题， 我们将采用另一项纳米生物技术，

and that has to do with the kidney.

与肾脏有关。

The kidney is a filter.

肾脏就是一个过滤装置。

Its job is to filter out the blood and put waste into the urine.

它的工作是把血液中的废物 过滤出来形成尿液。

It turns out that what the kidney filters

事实发现肾脏的过滤系统

is also dependent on size.

也是依据（过滤物的）大小。

So in this image, what you can see

所以在这个图中，你可以看到

is that everything smaller than five nanometers

所有小于5纳米的东西

is going from the blood, through the kidney, into the urine,

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。

and everything else that's bigger is retained.

OK, so if I make a 100-nanometer cancer detector,

好，那如果我制造一个 100纳米的癌症检测装置，

I inject it in the bloodstream,

注射到血流中，

it can leak into the tumor where it's activated by tumor enzymes

它可以渗漏到肿瘤 并被肿瘤的酶激发，

to release a small signal

释放出很小的信号，

that is small enough to be filtered out of the kidney

小到可以被肾脏过滤出来

and put into the urine,

并进入尿液中。

I have a signal in the outside world that I can detect.

我就有了一个可以在体外探测到的信号。

OK, but there's one more problem.

好，但是还有另一个问题。

This is a tiny little signal,

这是个小而微弱的信号，

so how do I detect it?

我怎么来检测它？

Well, the signal is just a molecule.

实际上，信号就是一个分子。

They're molecules that we designed as engineers.

它们是我们作为工程师设计的分子。

They're completely synthetic, and we can design them

它们完全人工合成并且我们可以设计它们，

so they are compatible with our tool of choice.

所以它们和我们选用的工具相匹配。

If we want to use a really sensitive, fancy instrument

如果我们想使用一种非常灵敏先进的仪器

called a mass spectrometer,

叫做质谱仪，

then we make a molecule with a unique mass.

那我们可以让这个分子 有一个独特的质量。

Or maybe we want make something that's more inexpensive and portable.

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。

Then we make molecules that we can trap on paper,

那我们就制造出可以滞留在纸上的分子，

like a pregnancy test.

就像测孕试纸。

In fact, there's a whole world of paper tests

实际上试纸的应用已经非常广泛，

that are becoming available in a field called paper diagnostics.

以至于专门形成了试纸诊断领域。

Alright, where are we going with this?

那好，我们现在进展如何呢？

What I'm going to tell you next,

我接下来要告诉你们的，

as a lifelong researcher,

作为一个终身的研究人员，

represents a dream of mine.

代表了我的一个梦想。

I can't say that's it's a promise;

我不敢说那是一个诺言；

it's a dream.

这是一个梦想。

But I think we all have to have dreams to keep us pushing forward,

但是我想我们都应该有梦想来 鞭策我们前行，

even -- and maybe especially -- cancer researchers.

甚至——并且可能尤其是 针对癌症的研究者。

I'm going to tell you what I hope will happen with my technology,

我将告诉你们我所希望 用我的技术会发生的，

that my team and I will put our hearts and souls

我和我的团队将不遗余力

into making a reality.

让它变成现实。

OK, here goes.

这就是：

我希望有一天

I dream that one day,

instead of going into an expensive screening facility

不需要昂贵的筛选设备

to get a colonoscopy,

来进行结肠镜检查，

or a mammogram,

或乳房X线照片，

or a pap smear,

或制作帕氏涂片，

that you could get a shot,

而是只需要扎一针，

wait an hour,

等一个小时，

在试纸上进行一个尿检。

and do a urine test on a paper strip.

I imagine that this could even happen

我期待甚至可以不需要

without the need for steady electricity,

稳定的电力供应，

or a medical professional in the room.

或者一位医务工作者呆在诊室。

Maybe they could be far away

也许他们在很远的地方，

and connected only by the image on a smartphone.

只通过智能手机上的图像进行联系。

Now I know this sounds like a dream,

现在我知道这听起来不太现实，

but in the lab we already have this working in mice,

但是在实验室中 我们已经在老鼠体内取得了进展，

where it works better than existing methods

它对于肺癌和卵巢癌的检测结果

for the detection of lung, colon and ovarian cancer.

比现行的任何一种方法都要好。

And I hope that what this means

我希望这意味着

is that one day we can detect tumors in patients

有一天我们可以很快检查出 病人体内的肿瘤，

sooner than 10 years after they've started growing,

不必等到十年后它们已成型，

in all walks of life,

在各行各业，

all around the globe,

全球各地都是如此，

and that this would lead to earlier treatments,

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，

and that we could save more lives than we can today,

with early detection.

只需依赖早期检测。

Thank you.

谢谢。

(Applause)

（掌声）