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

110,033 views ・ 2016-06-07

TED


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譯者: 易帆 余 審譯者: Max Chern
00:12
In the space that used to house one transistor,
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過去可容納一個電晶體的空間,
00:16
we can now fit one billion.
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我們現在可以放進 10 億個。
00:19
That made it so that a computer the size of an entire room
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這使得過去一個房間大小的電腦
00:23
now fits in your pocket.
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現在可以放進你的口袋裡了。
00:26
You might say the future is small.
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你可能會說,未來的東西會是小的。
00:29
As an engineer,
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身為一位工程師,
00:30
I'm inspired by this miniaturization revolution in computers.
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我被這個電腦的 微型化革命所啟發。
00:34
As a physician,
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而身為一位醫師,
00:36
I wonder whether we could use it to reduce the number of lives lost
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我在想,我們是否可以利用它來降低
00:41
due to one of the fastest-growing diseases on Earth:
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癌症 ─ 地球上成長最快速的疾病之一 的死亡人數。
00:46
cancer.
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00:47
Now when I say that,
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現在,當我這樣說時,
00:48
what most people hear me say is that we're working on curing cancer.
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大部份聽到的人會說, 我們是研究癌症治療的。
00:52
And we are.
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的確是!
00:53
But it turns out
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但事實上,
00:55
that there's an incredible opportunity to save lives
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有一個不可思議的機會 可以拯救生命,
00:57
through the early detection and prevention of cancer.
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就是藉由癌症的早期發現與預防。
01:01
Worldwide, over two-thirds of deaths due to cancer are fully preventable
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全球因癌症死亡的病例 超過 2/3 是可預防的 ,
01:07
using methods that we already have in hand today.
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經由使用我們現今已有的方法,
01:10
Things like vaccination, timely screening
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像是接種疫苗、定期篩檢,
01:13
and of course, stopping smoking.
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當然,戒菸也是。
01:16
But even with the best tools and technologies that we have today,
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但即使現在我們已經有 最好的工具與科技,
01:19
some tumors can't be detected
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某些腫瘤要開始成長十年後 才能被偵測出來,
01:22
until 10 years after they've started growing,
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01:25
when they are 50 million cancer cells strong.
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那時的癌細胞已多達 5 千萬個了。
01:30
What if we had better technologies
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要是我們有更好的科技,
01:31
to detect some of these more deadly cancers sooner,
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可以更早偵測到更多這些致命的癌症,
01:35
when they could be removed,
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也就是在它們可以被移除
01:36
when they were just getting started?
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或剛長出時,那該有多好?
01:38
Let me tell you about how miniaturization might get us there.
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讓我向各位說明 微型化科技將如何讓我們做到。
01:43
This is a microscope in a typical lab
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這是一般實驗室裡的一台顯微鏡,
01:45
that a pathologist would use for looking at a tissue specimen,
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病理學家用它來觀察組織的樣本,
01:49
like a biopsy or a pap smear.
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例如活體切片或子宮頸抹片檢查。
01:51
This $7,000 microscope
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這台 $7000 美金的顯微鏡 ,
01:54
would be used by somebody with years of specialized training
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會被某些受多年專業訓練的人
01:57
to spot cancer cells.
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用來找出癌細胞。
02:00
This is an image from a colleague of mine at Rice University,
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這一張圖是來自我的 一位萊斯大學的同事
02:03
Rebecca Richards-Kortum.
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麗貝卡·理查茲卡頓,
02:04
What she and her team have done is miniaturize that whole microscope
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她和她的團隊所做的 就是把顯微鏡縮小成為一個
02:08
into this $10 part,
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價值十元的零件,
02:10
and it fits on the end of an optical fiber.
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並且可以裝在光纖的末端上。
02:13
Now what that means is instead of taking a sample from a patient
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意思是,不需要從病人身上取出檢體,
02:17
and sending it to the microscope,
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送到顯微鏡下觀察,
02:19
you can bring the microscope to the patient.
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而是你可以把顯微鏡放到病人體內。
02:22
And then, instead of requiring a specialist to look at the images,
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並且,不需要專家來檢視影像,
02:26
you can train the computer to score normal versus cancerous cells.
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你可以訓練電腦區分 正常細胞與癌症細胞。
02:32
Now this is important,
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這很重要,
02:33
because what they found working in rural communities,
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因為他們發現在郊區工作,
02:36
is that even when they have a mobile screening van
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即使有一台行動篩檢箱型車,
02:39
that can go out into the community and perform exams
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可以開到社區裡進行檢查,
02:42
and collect samples
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及收集檢體
02:43
and send them to the central hospital for analysis,
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並把它們送回醫院做分析,
02:47
that days later,
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過幾天後,
02:48
women get a call with an abnormal test result
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受測女士們接到 檢查結果不正常的電話,
02:51
and they're asked to come in.
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並被要求到醫院來,
02:52
Fully half of them don't turn up because they can't afford the trip.
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但她們至少有一半不會來, 因為付不起旅費。
02:57
With the integrated microscope and computer analysis,
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藉由整合顯微鏡與電腦分析,
03:01
Rebecca and her colleagues have been able to create a van
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麗貝卡和她的同事 已經可以做出一台
03:04
that has both a diagnostic setup and a treatment setup.
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同時具有診斷與治療設施的廂型車。
03:07
And what that means is that they can do a diagnosis
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意思就是,他們可以直接在現場
03:10
and perform therapy on the spot,
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做診斷與治療,
03:13
so no one is lost to follow up.
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這樣就沒人會錯過追蹤了。
03:15
That's just one example of how miniaturization can save lives.
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這僅是一個微型化科技 如何拯救人命的案例之一。
03:20
Now as engineers,
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身為工程師,
03:21
we think of this as straight-up miniaturization.
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我們認為這就是微型化,
03:24
You took a big thing and you made it little.
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你把一個大的東西變小了。
03:26
But what I told you before about computers
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但我稍早跟各位提到 有關於電腦
03:28
was that they transformed our lives
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改變了我們的生活,
03:31
when they became small enough for us to take them everywhere.
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當它們變得 小到可以讓我們帶到任何地方時。
03:35
So what is the transformational equivalent like that in medicine?
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在醫學上, 有什麼東西是相對等的改變呢?
03:40
Well, what if you had a detector
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如果你有一個偵測器,
03:43
that was so small that it could circulate in your body,
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它小到可以在你的體內循環,
03:47
find the tumor all by itself
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並靠它自己找到腫瘤,
03:50
and send a signal to the outside world?
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而且還能把訊號傳到體外呢?
03:53
It sounds a little bit like science fiction.
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這聽起來有點像科幻小說,
03:55
But actually, nanotechnology allows us to do just that.
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但實際上,奈米科技 已經可以讓我們做到了。
03:59
Nanotechnology allows us to shrink the parts that make up the detector
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奈米科技已經讓我們能夠 把製造偵測器的零件
04:04
from the width of a human hair,
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從原本是頭髮寬度即100微米
04:06
which is 100 microns,
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04:07
to a thousand times smaller,
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縮更小到其 1/1000,
04:10
which is 100 nanometers.
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也就是100奈米。
04:12
And that has profound implications.
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這樣就有很大的影響了,
04:15
It turns out that materials actually change their properties
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也就是說,材質實際上 以奈米規格改變其特性。
04:19
at the nanoscale.
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04:21
You take a common material like gold,
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就拿黃金這個普遍的材質來說,
04:23
and you grind it into dust, into gold nanoparticles,
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當你把黃金磨到奈米粒子的大小,
04:27
and it changes from looking gold to looking red.
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它會從金色變成紅色。
04:31
If you take a more exotic material like cadmium selenide --
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如果你再拿一個更奇特的材質, 像是硒化鎘 ──
04:34
forms a big, black crystal --
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一個大而黑的晶體,
04:37
if you make nanocrystals out of this material
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若把它製成奈米大小,
04:39
and you put it in a liquid,
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然後放進一種液體裡,
04:41
and you shine light on it,
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並以光線照射它
04:43
they glow.
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它們會發光。
04:44
And they glow blue, green, yellow, orange, red,
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它們會發出藍色、綠色、 黃色、橘色、紅色的光,
04:50
depending only on their size.
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僅依據它們的大小不同。
04:52
It's wild! Can you imagine an object like that in the macro world?
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這太神奇了!你可想像 這樣一個在宏觀世界裡的物體嗎?
04:56
It would be like all the denim jeans in your closet are all made of cotton,
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就好比你衣櫃裡那些 全都是棉製的牛仔褲,
05:03
but they are different colors depending only on their size.
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會依它們的尺寸大小 而有不同的顏色。
05:08
(Laughter)
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(笑聲)
05:10
So as a physician,
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所以,身為一位醫師,
05:12
what's just as interesting to me
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讓我感興趣的
05:14
is that it's not just the color of materials
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不只是材質 會依奈米規格的大小而改變顏色;
05:17
that changes at the nanoscale;
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05:19
the way they travel in your body also changes.
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它們在你身體裡面的 運行方式也會改變。
05:23
And this is the kind of observation that we're going to use
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而我們將運用這種觀察方式
05:25
to make a better cancer detector.
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來製作更好的癌症偵測器。
05:28
So let me show you what I mean.
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讓我向各位解釋一下,
05:30
This is a blood vessel in the body.
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這是身體裡面的一條血管,
05:32
Surrounding the blood vessel is a tumor.
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圍繞著血管的是一個腫瘤。
05:35
We're going to inject nanoparticles into the blood vessel
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我們把奈米粒子注射到血管裡面,
05:38
and watch how they travel from the bloodstream into the tumor.
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然後觀察它們如何從 血流中進到腫瘤裡面。
05:43
Now it turns out that the blood vessels of many tumors are leaky,
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結果我們看到 許多腫瘤的血管有漏洞,
05:47
and so nanoparticles can leak out from the bloodstream into the tumor.
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所以奈米粒子會從血流漏向腫瘤,
05:52
Whether they leak out depends on their size.
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它們是否會漏出去 取決於它們的大小。
05:56
So in this image,
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在這影像
05:57
the smaller, hundred-nanometer, blue nanoparticles are leaking out,
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較小、100奈米的 藍色奈米粒子正在漏出去,
06:01
and the larger, 500-nanometer, red nanoparticles
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較大、500奈米的紅色奈米粒子
06:05
are stuck in the bloodstream.
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則留在血流當中。
06:06
So that means as an engineer,
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所以身為一位工程師,
06:09
depending on how big or small I make a material,
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依據我所製作的物質大小,
06:13
I can change where it goes in your body.
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可改變它在你身體裡的去處。
06:17
In my lab, we recently made a cancer nanodetector
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在我的實驗室,我們最近 作出一種癌症奈米偵測器,
06:21
that is so small that it could travel into the body and look for tumors.
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它小到可以進入身體並找尋腫瘤,
06:27
We designed it to listen for tumor invasion:
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我們設計它用來監聽腫瘤的侵犯:
06:31
the orchestra of chemical signals that tumors need to make to spread.
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腫瘤需要製造這些 化學訊號的樂音來擴散。
06:36
For a tumor to break out of the tissue that it's born in,
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腫瘤為了要從它長出來的 組織突破出去,
06:39
it has to make chemicals called enzymes
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它必須製造一種 稱為「酵素」的化學物質,
06:42
to chew through the scaffolding of tissues.
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來穿破組織架構而出。
06:45
We designed these nanoparticles to be activated by these enzymes.
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我們設計這些奈米粒子 可被腫瘤酵素活化,
06:51
One enzyme can activate a thousand of these chemical reactions in an hour.
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一個酵素一小時內 可活化一千個這種化學反應。
06:57
Now in engineering, we call that one-to-a-thousand ratio
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用工程術語來說,我們稱這種 1:1000 比率為一種放大率,
07:01
a form of amplification,
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07:02
and it makes something ultrasensitive.
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它會變得超靈敏。
07:04
So we've made an ultrasensitive cancer detector.
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所以我們製造出一種 超靈敏的癌症偵測器,
07:09
OK, but how do I get this activated signal to the outside world,
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但我要如何把這個活化訊號傳到體外,
07:14
where I can act on it?
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我要從那裡著手呢?
07:15
For this, we're going to use one more piece of nanoscale biology,
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為此,我們要再利用另一個 奈米規格生物學,
07:19
and that has to do with the kidney.
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而這與腎臟有關。
07:21
The kidney is a filter.
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腎臟是一種過濾器,
07:23
Its job is to filter out the blood and put waste into the urine.
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它的功能就是將廢物 從血液濾出並排入尿液,
07:29
It turns out that what the kidney filters
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其實腎臟所過濾的物質
07:31
is also dependent on size.
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也是根據大小而定。
07:34
So in this image, what you can see
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所以在這影片,各位可以看到
07:36
is that everything smaller than five nanometers
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任何小於 5 奈米的物質,
07:39
is going from the blood, through the kidney, into the urine,
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會從血液通過腎臟而排入尿液,
07:44
and everything else that's bigger is retained.
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其他比較大的物質會被留下來。
07:47
OK, so if I make a 100-nanometer cancer detector,
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好,如果我做了一個 100 奈米的癌症偵測器,
07:52
I inject it in the bloodstream,
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然後把它注射到血流裡面,
07:54
it can leak into the tumor where it's activated by tumor enzymes
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它會漏入腫瘤裡面, 被腫瘤酵素活化,
08:00
to release a small signal
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並釋放一種微小訊號,
08:02
that is small enough to be filtered out of the kidney
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小到可以被腎臟過濾出來,
08:05
and put into the urine,
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然後排到尿液裡面,
08:07
I have a signal in the outside world that I can detect.
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這樣在體外 就有我可以偵測到的訊號了。
08:12
OK, but there's one more problem.
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好,但還有一個問題。
08:14
This is a tiny little signal,
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這是一個很微小的訊號,
08:16
so how do I detect it?
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我要如何偵測呢?
08:18
Well, the signal is just a molecule.
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訊號其實只是一種分子,
08:20
They're molecules that we designed as engineers.
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是我們工程師設計出來的分子。
08:23
They're completely synthetic, and we can design them
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它們完全是合成的, 我們可以設計它們,
08:26
so they are compatible with our tool of choice.
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讓它與我們選擇的工具完全相容。
08:30
If we want to use a really sensitive, fancy instrument
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如果我們要用一種 相當靈敏的昂貴設備 ──
08:33
called a mass spectrometer,
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叫做質譜儀,
08:35
then we make a molecule with a unique mass.
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那麼我們會製造 一種特定質量的分子。
08:38
Or maybe we want make something that's more inexpensive and portable.
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或許我們想讓它 不那麼昂貴且方便攜帶,
08:42
Then we make molecules that we can trap on paper,
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那麼我們會製造 能被試紙抓住的分子,
08:46
like a pregnancy test.
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就像驗孕一樣。
08:47
In fact, there's a whole world of paper tests
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事實上,現在有很多的試紙測試方法,
08:50
that are becoming available in a field called paper diagnostics.
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已廣泛應用在「試紙診斷」領域了。
08:55
Alright, where are we going with this?
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好的,我們做這個有什麼用處呢?
08:58
What I'm going to tell you next,
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接下來我要告訴各位的是
09:00
as a lifelong researcher,
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身為一位終身研究員,
09:02
represents a dream of mine.
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我想對各位訴說我的夢想。
09:04
I can't say that's it's a promise;
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我不能說這是個承諾;
09:06
it's a dream.
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但它至少是個夢想。
09:08
But I think we all have to have dreams to keep us pushing forward,
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我認為我們都必須有夢想 來讓我們向前邁進,
09:11
even -- and maybe especially -- cancer researchers.
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甚至,特別是癌症研究人員。
09:15
I'm going to tell you what I hope will happen with my technology,
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我要告訴各位我期望 我的技術將來會有何進展,
09:19
that my team and I will put our hearts and souls
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我的團隊和我都會盡心盡力地
讓這期望成真。
09:23
into making a reality.
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09:25
OK, here goes.
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好的,我要開始了。
09:27
I dream that one day,
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我夢想有一天,
09:30
instead of going into an expensive screening facility
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大家不用再使用昂貴的篩檢設備
09:33
to get a colonoscopy,
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來做大腸鏡檢查
09:35
or a mammogram,
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或乳房攝影檢查
09:36
or a pap smear,
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或子宮頸抹片檢查,
09:38
that you could get a shot,
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而是你可能扎一針,
09:40
wait an hour,
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等一個小時,
09:42
and do a urine test on a paper strip.
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然後在試紙上做尿液檢測即可。
09:45
I imagine that this could even happen
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我想像這甚至
不需要穩定的電流 或專業醫療人士在檢驗室裡就可能做到。
09:48
without the need for steady electricity,
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09:51
or a medical professional in the room.
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09:53
Maybe they could be far away
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或許他們可以遠隔千里
09:55
and connected only by the image on a smartphone.
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僅用智能手機連結影像即可。
09:58
Now I know this sounds like a dream,
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我知道這聽起來像是個夢想,
10:00
but in the lab we already have this working in mice,
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但在實驗室, 我們已經用在老鼠身上了,
10:03
where it works better than existing methods
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對於偵測肺癌、大腸癌及卵巢癌, 這比現行方法更有用。
10:05
for the detection of lung, colon and ovarian cancer.
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10:10
And I hope that what this means
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而這也意味著我期望
10:12
is that one day we can detect tumors in patients
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有一天,在病人腫瘤開始成長的10年內, 我們就可以偵測到。
10:18
sooner than 10 years after they've started growing,
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10:21
in all walks of life,
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在各行各業、世界各地的人都能受惠,
10:23
all around the globe,
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10:25
and that this would lead to earlier treatments,
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這會促成早期治療,
10:28
and that we could save more lives than we can today,
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藉由早期發現, 我們能比今日拯救更多人的性命。
10:31
with early detection.
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10:33
Thank you.
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謝謝!
10:34
(Applause)
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(掌聲)
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