The Future of Early Cancer Detection? | Jorge Soto | TED Talks

翻译人员: Stephanie Yu 校对人员: Wei Wu

Almost a year ago,

差不多一年以前

my aunt started suffering back pains.

我的一个阿姨开始觉得背部疼痛

She went to see the doctor

她去医院检查

and they told her it was a normal injury

医生们告诉她， 对于过去30年从事网球运动的人来说

for someone who had been playing tennis

for almost 30 years.

这只是普通伤痛

They recommended that she do some therapy,

医生们建议她进行一些治疗

but after a while she wasn't feeling better,

但是过了一阵她并没有感觉有任何好转

so the doctors decided to do further tests.

所以医生们决定进一步的做一些检查

They did an x-ray

他们做了X光

and discovered an injury in her lungs,

然后找到了她肺部的一个伤口

and at the time they thought that the injury

当时医生们仍然觉得那个伤口

was a strain in the muscles and tendons

是她肋骨之间的

between her ribs,

肌肉或者肌腱的拉伤

but after a few weeks of treatment,

不过，经过好几周的治疗

again her health wasn't getting any better.

伤痛仍然没有好转

So finally, they decided to do a biopsy,

最后，医生们决定做一次活体组织检验

and two weeks later,

于是，两周之后

the results of the biopsy came back.

活体组织检验的结果出来了

It was stage 3 lung cancer.

结果是肺癌，已经到了第三期

Her lifestyle was almost free of risk.

她的生活方式非常健康

She never smoked a cigarette,

她从来不抽烟

she never drank alcohol,

从来不喝酒

and she had been playing sports

体育事业占据了她几乎半生

for almost half her life.

Perhaps, that is why it took them almost six months

也许，这正是医生们花了六个月的时间

to get her properly diagnosed.

才对她做出了正确诊断的原因吧

My story might be, unfortunately,

不幸的是，我的故事可能

familiar to most of you.

让你们都觉得熟悉

One out of three people sitting in this audience

在座的三分之一的听众们

will be diagnosed with some type of cancer,

都可能被诊断为某种癌症

and one out of four

并且四分之一的人

will die because of it.

会因此而死亡

Not only did that cancer diagnosis

改变我们整个家庭生活的，

change the life of our family,

不仅是被诊断为癌症的结果，

but that process of going

还有那些反复做各种新检测的过程，

back and forth with new tests,

different doctors describing symptoms,

以及不停地向不同的医生描述症状

discarding diseases over and over,

又反反复复的推翻之前诊断的过程，

was stressful and frustrating,

这些都让人承受着巨大的压力

尤其让阿姨十分沮丧

especially for my aunt.

And that is the way cancer diagnosis has been done

但是，从有历史以来

since the beginning of history.

癌症的诊断就是以这种方式进行的

We have 21st-century medical treatments and drugs

我们用21世纪的医疗设备和药物

to treat cancer,

来治疗癌症

but we still have 20th-century procedures

却还在用20世纪的流程和手续来诊断癌症

and processes for diagnosis, if any.

如果这能被称作流程的话

Today, most of us have to wait for symptoms

今天，大多数诊断都依赖于症状的表现

to indicate that something is wrong.

Today, the majority of people still don't have access

今天，我们中的绝大多数仍然没有

to early cancer detection methods,

诊断早期癌症的方法

even though we know

即便我们知道

that catching cancer early

癌症的早期发现

is basically the closest thing we have

基本上是我们所能做的

to a silver bullet cure against it.

最好的治愈癌症的良方

We know that we can change this in our lifetime,

我们知道我们可以 在我们有生之年改变这种状况

and that is why my team and I

这就是我和我的团队

have decided to begin this journey,

决定开始这一段旅程的原因

this journey to try to make cancer detection

这一段旅程的目的就是尝试

at the early stages

癌症的早期诊断

and monitoring the appropriate response at the molecular level

并且在分子的维度监控适当的反应

easier, cheaper, smarter

更简单、更便宜、更智慧

and more accessible than ever before.

并且前所未有的更有可行性

The context, of course,

当然，这事情的背景是

is that we're living at a time

我们生活的现在这个时代

where technology is disrupting our present

科学技术正在

at exponential rates,

以惊人的速度发展着

and the biological realm is no exception.

生物领域也没有例外

It is said today that biotech is advancing

据说现在生物技术的发展的速度

at least six times faster than the growth rate

比计算机处理能力的增长

of the processing power of computers.

还要至少快六倍

But progress in biotech

但是生物技术领域的进步

is not only being accelerated,

并不仅仅是速度的增长

it is also being democratized.

而且也更加的大众化

Just as personal computers or the Internet

就像个人电脑或互联网

or smartphones leveled the playing field

或智能手机拓宽了商业、政治和教育

for entrepreneurship, politics or education,

的舞台一样

recent advances have leveled it up for biotech progress as well,

最近的科技发展同样更新了 生物技术的发展水平

and that is allowing

这让我们这样的

multidisciplinary teams like ours

来自不同领域的人组成的团队

to try to tackle and look at these problems

可以使用一些新的途径

with new approaches.

去尝试解决和攻克一些难题

We are a team of scientists and technologists

我们的团队由来自智利、巴拿马

from Chile, Panama,

墨西哥、以色列和希腊的

Mexico, Israel and Greece,

科学家和技术人员组成

and based on recent scientific discoveries,

在最近的科学发现的基础上

we believe that we have found

我们相信我们已经找到了

a reliable and accurate way

一种可靠和准确的方式

of detecting several types of cancer

在很早的阶段，通过血液样本检测来

at the very early stages through a blood sample.

诊断几种癌症

We do it by detecting a set of very small molecules

我们通过检测一组在我们血液中自由流动的

that circulate freely in our blood

细胞分子来做诊断

called microRNAs.

它们被称为微型RNA

To explain what microRNAs are

为了解释微型RNA是什么

and their important role in cancer,

以及它们在癌症当中扮演的重要角色

I need to start with proteins,

我需要从蛋白质开始

because when cancer is present in our body,

因为当我们的身体中出现癌症时

protein modification is observed

我们观察到了所有的癌细胞都在进行

in all cancerous cells.

“蛋白质的修饰”

As you might know,

你可能知道

proteins are large biological molecules

蛋白质是一种大型的生物分子

that perform different functions within our body,

蛋白质在我们的身体里面执行不同的功能

like catalyzing metabolic reactions

比如促进新陈代谢反应

or responding to stimuli

或对外部刺激做出反应

or replicating DNA,

或者复制DNA

but before a protein is expressed or produced,

但是，在蛋白质被生成或表达之前

relevant parts of its genetic code

它的DNA中的

present in the DNA

基因编码的相应部分

are copied into the messenger RNA,

也会被复制到信使RNA中

so this messenger RNA

因此，这个信使RNA

has instructions on how to build a specific protein,

掌握了如何生成一种特定蛋白质的指令

and potentially it can build hundreds of proteins,

实际上，信使RNA可以生成好几百中不同的蛋白质

but the one that tells them when to build them

但是告诉它什么时候生成

and how many to build

以及生成多少的

are microRNAs.

是微型RNA

So microRNAs are small molecules

微型RNA是一种

that regulate gene expression.

规范基因表达的小分子

Unlike DNA, which is mainly fixed,

和基本固定的DNA不一样

microRNAs can vary depending on internal

微型RNA根据不同时间的内部和外部环境因素

and environmental conditions at any given time,

可能各不相同

telling us which genes are actively expressed at that particular moment.

它告诉我们在一个特定时间，哪些基因是主动表达的

And that is what makes microRNAs

这就是微型RNA

such a promising biomarker for cancer,

这真是一个很好的癌症的生物标记

because as you know,

因为，你应该知道的

cancer is a disease of altered gene expression.

癌症是一种基因表达改变的疾病

It is the uncontrolled regulation of genes.

它是基因规则不受控制的结果

Another important thing to consider

另一件值得考虑的重要的事情是

is that no two cancers are the same,

没有任何两种癌症是一模一样的

but at the microRNA level, there are patterns.

不过，在微型RNA的角度，有一些规律可循

Several scientific studies have shown

一些科学研究表明

that abnormal microRNA expression levels

不正常的微型RNA表达的等级

varies and creates a unique, specific pattern

根据不同的癌症

for each type of cancer,

有不同的、独特的模型

even at the early stages,

即便是在早期

reflecting the progression of the disease,

可以反映疾病的发展状况

and whether it's responding to medication

另外，在对判断治疗是否有效

or in remission,

或疾病是否有所缓解的判断上

making microRNAs a perfect,

微型RNA绝对是一个完美的

highly sensitive biomarker.

高度敏感的生物标记

However, the problem with microRNAs

不过，微型RNA的问题在于

is that we cannot use existing DNA-based technology

现有的基于DNA的科技

to detect them in a reliable way,

无法做到可靠的识别它们

because they are very short sequences of nucleotides,

因为它们是一串非常短序列的核苷酸

much smaller than DNA.

比DNA小得多

And also, all microRNAs are very similar to each other,

也正因为如此，所有的微型RNA都看起来差不多

with just tiny differences.

可能仅仅有很细微的差别

So imagine trying to differentiate two molecules,

所以，想象一下，尝试分辨

extremely similar, extremely small.

两个极其相似，又极其微小的分子

We believe that we have found a way to do so,

我们相信我们找到一个方法

and this is the first time that we've shown it in public.

这是我们第一次公开的展示

Let me do a demonstration.

请让我们做一个示范

Imagine that next time you go to your doctor

想象一下，下一次你去找医生的时候

and do your next standard blood test,

做常规的血液测试

a lab technician extracts a total RNA,

实验室技术人员分离出一个完整的RNA

which is quite simple today,

这其实在现在非常简单

and puts it in a standard 96-well plate like this one.

然后把它放到到一个标准的96孔板--就像这个一样

Each well of these plates

我们给这个板的每一个孔都分配

has specific biochemistry that we assign,

一个特定的生化指标

that is looking for a specific microRNA,

用来寻找一个特定的微型RNA

acting like a trap that closes

就好像一个陷阱

only when the microRNA is present in the sample,

仅在特定的微型RNA在样本里出现时才会启动

and when it does, it will shine with green color.

并且陷阱启动的时候，它会变成绿色

To run the reaction,

为了做这个测试

you put the plate inside a device like this one,

你将这个板放进一个设备--好像这一个

and then you can put your smartphone on top of it.

之后你可以把你的智能手机放在它上面

If we can have a camera here

如果在这里我们可以有一个摄像头

so you can see my screen.

你就可以看到我的视野了

A smartphone is a connected computer

智能手机是一个联网的计算机

and it's also a camera,

同时它也是一个相机

good enough for our purpose.

这已经足够帮助我们了

The smartphone is taking pictures,

智能手机在这里不停的照相

and when the reaction is over,

当这里的反应结束

it will send the pictures

它会把这些照片

to our online database for processing

发送到我们的网上处理中心

and interpretation.

进行处理和翻译

This entire process lasts around 60 minutes,

整个过程大概需要60分钟

but when the process is over,

不过当这个过程结束之时

wells that shine are matched with the specific microRNAs

变绿的孔是和特定的微型RNA相匹配的

and analyzed in terms of how much and how fast

并且已经分析了它们变绿的

they shine.

数量和速度

And then, when this entire process is over,

之后，整个过程结束之后

this is what happens.

这是将要发生的

This chart is showing the specific microRNAs

这一张图表展示了

present in this sample

这一个样本里存在的特定微型RNA

and how they reacted over time.

以及它们如何随时间进行反应

Then, if we take this specific pattern of microRNA

然后，如果我们采集这个人的样本中

of this person's samples

微型RNA的特定模型

and compare it with existing scientific documentation

然后和现有的与微型RNA模型有关的

that correlates microRNA patterns

科学资料进行对比

with a specific presence of a disease,

如果有一种特定的疾病

this is how pancreatic cancer looks like.

这就是胰腺癌看起来的样子

This inside is a real sample

这里面的是一个真正的样本

where we just detected pancreatic cancer.

在里面我们诊断了胰腺癌

(Applause)

（掌声）

Another important aspect of this approach

关于这个方法的另外一个重要的方面是

is the gathering and mining of data in the cloud,

收集和挖掘云端的数据

so we can get results in real time

我们才能实时的得到结果

and analyze them with our contextual information.

才能够结合我们掌握的信息进行分析

If we want to better understand

如果我们希望更好的

and decode diseases like cancer,

理解和解决癌症这样的疾病

we need to stop treating them

我们就不能把它们当成

as acute, isolated episodes,

急性的、独立的片段

and consider and measure everything

我们要考虑和测试一切

that affects our health on a permanent basis.

可能永久的影响我们的健康的因素

This entire platform is a working prototype.

这整个平台是一个工作原型

It uses state-of-the-art molecular biology,

它使用当前最新的分子生物技术

a low-cost, 3D-printed device,

一种低成本的3D打印设备

and data science

以及数据科学

to try to tackle one of humanity's toughest challenges.

来尝试攻克一个人类历史上最难的挑战

Since we believe early cancer detection

我们相信早期的癌症诊断

should really be democratized,

绝对应该被普及到大众

this entire solution costs at least 50 times less

这一套完整的解决方案与 现有可行的方法相比

than current available methods,

至少在成本上要便宜50倍

and we know that the community can help us

我们还相信社区能帮助我们

accelerate this even more,

进一步的加速这个方案的实施

so we're making the design of the device

因此我们把这个设备的设计

open-source.

进行了开源

(Applause)

（掌声）

Let me say very clearly

让我非常明确的说一句

that we are at the very early stages,

我们是在很初步的阶段

but so far, we have been able

但是到目前为止

to successfully identify the microRNA pattern

我们已经成功的识别出了

of pancreatic cancer, lung cancer,

胰腺癌、肺癌、乳腺癌

breast cancer and hepatic cancer.

和肝癌的微型RNA模型

And currently, we're doing a clinical trial

现在，我们与德国癌症研究中心合作

in collaboration with the German Cancer Research Center

正在对200名女性

with 200 women for breast cancer.

进行乳腺癌诊断的临床试验

(Applause)

（掌声）

This is the single non-invasive,

这是一种无侵入性

accurate and affordable test

准确的，并且并不昂贵的测试

that has the potential to dramatically change

而这个测试具有巨大的潜力

how cancer procedures and diagnostics

它可能会极大的改变

have been done.

癌症诊断和治疗的方法

Since we're looking for the microRNA patterns

鉴于我们可以在任何特定时间

in your blood at any given time,

在你的血液样本中寻找微型RNA模式

you don't need to know which cancer you're looking for.

你不需要要求检查哪一种癌症

You don't need to have any symptoms.

你也不必要一定有症状

You only need one milliliter of blood

你只需要1毫升的血液

and a relatively simple array of tools.

以及一组相对简单的工具

Today, cancer detection happens mainly

如今，癌症的诊断

when symptoms appear.

只会在症状显现的时候进行

That is, at stage 3 or 4,

那基本就是第三阶段或者第四阶段了

and I believe that is too late.

这已经太晚了

It is too expensive for our families.

对我们的家庭来说，这代价太高

It is too expensive for humanity.

对人类来说，这代价太高

We cannot lose the war against cancer.

我们不能输掉对抗癌症的战争

It not only costs us billions of dollars,

这场战争不仅仅消耗我们数亿美金

but it also costs us the people we love.

它还会让我们付出失去我们所爱的人的代价

Today, my aunt, she's fighting bravely

现在，我的阿姨正在勇敢的、以积极的心态

and going through this process with a very positive attitude.

和癌症做斗争

However, I want fights like this

只不过，我希望这样的斗争

to become very rare.

变得极为少见

I want to see the day

我希望看到那一天

when cancer is treated easily

癌症由于可以被常规的诊断出来

because it can be routinely diagnosed

而使得其可以在早期

at the very early stages,

被轻松的治愈

and I'm certain

我相信

that in the very near future,

这一天就快到来了

because of this

因为它

and other breakthroughs that we are seeing

以及其他的我们所看到的科技突破

every day in the life sciences,

生命科学的每一天

the way we see cancer

我们看待癌症的方式

will radically change.

将会发生明显的变化

It will give us the chance of detecting it early,

科技的发展让我们可以及早的诊断癌症

understanding it better,

更好的了解癌症

and finding a cure.

更好的找到治疗的方法

Thank you very much.

非常感谢

(Applause)

（掌声）