TEDMED2016.5.12---Sangeeta Bhatia :納米癌症檢測儀

TEDMED2016.5.12---Sangeeta Bhatia :納米癌症檢測儀
發佈日期：2016年5月12日
Harvard-MIT physician, bioengineer and entrepreneur Sangeeta Bhatia shares how she led her multidisciplinary lab to develop an unusual breakthrough in cancer diagnostics.
While this talk was originally created with Sangeeta in partnership with TEDMED, we were honored to support her in also sharing this talk at TED Broadway in partnership with PBS.
哈佛 - 麻省理工医师，生物工程学家和企业家桑吉塔巴蒂亚股怎么她带领的多学科实验室，共同开发癌症诊断的一个不寻常的突破。
虽然这次谈话与桑吉塔合作最初创建与TEDMED，我们有幸邀请到了支持她还与PBS分享在TED百老汇这次谈话的合作伙伴关系。





==========Google 翻译==========

0:21single transistor we can now fit one billion and that made it so a computer 0:35the size of an entire room now fits in your pocket and that enabled the 0:41invention of things like smartphones and Fitbit than GPS tracking devices you 0:46might say the future 0:47small as an engineer and inspired by this new jersey Asian revolution in 0:53computers as a physician I'm optimistic about what miniaturization can do for 0:59human health I wonder whether we could use it to reduce the number of life by

1:06due to one of the fastest growing diseases on earth 1:10camper when I say that what most people hear me say that we're working on curing 1:15cancer and we are but it turns out that there's an extraordinary opportunity to 1:21save lives through the early detection and prevention of cancer worldwide over 1:26two-thirds of cancer death are entirely preventable using measures we already 1:31know about today they include vaccines cleaning and of course stopping smoking 1:38but even using the best tools and technologies that we have available we 1:43can't find some tumors until ten years after they've started growing when they 1:48are some 15 million cancer cells strong so what if we had better technologies to 1:54test the depth of the most deadly cancers earlier when they were just 1:58getting started and could be 1:59moved while the vision is that we could see even more alive let me show you how

2:04many trees Asian I get us there this is a microscope that you would find in a 2:09standard pathology lab and it would be used for inspecting it tissue specimen 2:13like a biopsy reports where the person looking in this $7,000 microscope would 2:19be a pathologist with the years of specialized training in how to spot 2:23cancer cells now compare that to this this is an image from my colleague at 2:28Rice University Rebecca Richards quarter in which she entertainment john is a 2:32miniaturised microscope so that it fits onto the end of an optical fiber and a 2:38$10 part now what that means is that instead of taking a sample from the 2:43patient to the microscope you can bring the microscope to the patient and then 2:49instead of relying on an expert to look at the images what she and her team are 2:53doing is treat to train the computer to automatically score healthy versus 2:57cancerous tissues so a decision to treat could be made in the moment it now this

3:02is important because what they found that even when they have mobile 3:06screening trucks that go out into the community and rural communities and 3:10perform cervical exams and take samples and send them to the lab that days later 3:15when women get called that an abnormal test results and asked to come in 3:19fully half of them don't turn up simply because they can't afford the trip now 3:24with the new fiber optic microscope and automatic computer scoring they've been 3:28able to create an integrated diagnostic and treatment than this man can go out 3:34into the community 3:35make a diagnosis and provide treatment in the moment and no one has lost to 3:40follow so that's one example of how miniaturization might save life now as 3:46engineers we think of this is straight at miniaturization you talk a big thing 3:50and you made it a little but I told you about before it was the computers 3:54changed our lives completely with a became small enough for us to take them 3:58everywhere so what does the transformational equivalent of that look

4:03like in cancer detection what if we had a detector that was so slow 4:09mall but it could travel through your body I could find the tumor all by 4:13itself and it could send a signal to the outside world but I'm a little bit like 4:19science fiction actually nanotechnology allows us to do just that Nana 4:25technology has allowed us to shrink the parts that make up the detector from the 4:30width of a human hair which is a hundred microns life a thousand times smaller to 4:35a hundred nanometers and that has profound implications at that link get 4:40what we call the nanoscale materials actually change their properties so you 4:45can take a very common material like gold looks golden in your jewelry if you 4:50grind it down into dust into nanoparticles it actually looks red you 4:56can take a more exotic material like this big black crystal of cadmium

5:01selenide if you make nanocrystals out of this material and put them in liquid and 5:07shine my time they glow and they glow blue green yellow orange red depending 5:15only on their 50 can you imagine an object like that in the macro world it 5:22would be like all the denim jeans in your qui vit are all made of cotton and 5:28they glow different colors just because they are different 5:31wild right okay so it's not just the color of materials that changes at the 5:38nanoscale gail was just as interesting to me is that the way they travel inside 5:44your body also changes so here's a little movie to show you what I need 5:48this is a blood vessel in the body and around the blood vessel is a tumor ok 5:54we're going to inject nanoparticles in the blood vessel and watch how they 5:58travel from the bloodstream into the tumor now it turns out that the blood

6:04vessels of many tumors are leaky and so the nanoparticles can leak out whether 6:09or not they leaked out to Penn 6:11on their side so in this image what you see is that the smaller blue hundred 6:17nanometers nanoparticles can leaked out the larger read five hundred nanometers 6:22particles stay behind that means as an engineer 6:27depending on how big or small I make a material I can see where it goes in your 6:33eyes that's the kind of insight that we're going to try to exploit to make a 6:38better cancer detector in my lab we recently did make a detector that was so 6:43small that it could circulate in the body looking for tumors we designed this 6:48detector to listen for tumor invasion the orchestra of chemical signals that 6:54tumors need to spread for a tumor to spread out of the tissue in which it's 6:59born they make chemicals called enzymes but two of the scaffolding of the two

7:04suits and we designed our detector to be activated by these enzymes one and I'm 7:12can perform a fastened chemical reactions in an hour and engineering we 7:17call this one to a thousand reach you a form of amplification it would typically 7:21make a technology ultra sensitive so we've made an ultra sensitive cancer 7:26detector ok so mad Italian just how do we get this signal that's in the tumor 7:31to the outside world where we can detect it for that we're going to use another 7:37aspect of nanoscale biology and that has to do with the kidney for the kidneys 7:42filter and its job is to filter out waste from the blood and put it into the 7:47urine it turns out that the kidney is a size-dependent filter so when this movie 7:53what you're saying is that the smaller 5 nanometers particle can get out into the 7:58urine and everything larger is retained in the blood

8:02ok so let's put these three concepts together and show you how it works so 8:07what we've done is make a hundred nanometers cancer detector we injected 8:12in the bloodstream it leaks out into the tumor 8:16activated by enzymes in the tumor and a signal is released that is small enough 8:22to get filtered out by the kidney into the urine in the urine it's in the 8:28outside world where we can detect it 8:30ok so there's one last challenge how do we detect the signal in the urine if 8:35it's so tiny so it turns out that these signals are just molecules and they're 8:40completely synthetic molecules that we engineer but not the molecules that the 8:45kidney normally put from the year and what that means is that we can design 8:48them to be read out by a tool of choice so for example if we make the molecules 8:54have a unique math we can detect them with a fancy sensitive instrument called 8:58the mass spectrometer if instead we're interested in something that's very

9:02portable and inexpensive we can design the molecules to be trapped on something 9:07like paper like a home pregnancy test the choices engineers is up to us and it 9:13depends on the application that we have in mind now for interested in 9:16portability and we do to something like paper it turns out there's a whole new 9:20world of formats better emerging in this new field of people diagnostics that we 9:26have to choose from 9:27ok so where we goin when I'm gonna tell you next is my perspective as a lifelong 9:35researcher and it represents a dream I have I can't say it's a promise but it 9:41is a dream and I think we all deserve to have dreams even and maybe especially 9:46cancer researchers when I'm going to describe to you is what I hope will 9:50happen with my technology and what my team and I will dedicate our heart and 9:55souls into trying to make a reality I dream that one day instead of going into 10:04an expensive facility for screening colonoscopy for mammogram for a pap

10:09smear you get a shop wait an hour and do a urine test on a paper strip 10:19I imagine that this could happen even without the need for steady electricity 10:22or a medical professional in the room maybe they would be far away and 10:27connected only by the image on the smartphone I hope that this means that 10:32we could find tumors much sooner than 10 years after they've started growing 10:37impatience all around the world in all walks of life that this will lead to 10:43earlier treatment and that we could save even more alive than we can today 10:47through early detection ok so I know that sounds like a dream but actually 10:53we've made incredible progress in the lab already in my life where this 10:57technology is working for coal in ovarian and lung cancer detection and

11:03then next steps are to try and bring this to patients so the things we have 11:06to do our manufacturer a lot of these detectors at scale we have to show their 11:12safe for use in humans and of course that it works in order to make that 11:16happen 11:17we've assembled a team dedicated to translating their technology from the 11:22lab to patients how about giving you a sense of the power miniaturization and 11:28medicine I just want to close with this one thought about our world which is 11:34that you often hear people talking about how it's a small world our world is 11:37getting smaller more interconnected now through virtual conversation then we 11:42have them in any other time 11:44time in human history for me it's a small world but in a different way the 11:50future is small it's a world where miniaturization and medicine can come 11:55together to help us understand monitor and treat the human body in molecular 12:02conversation at the tiniest skills and in this small world for opportunities 12:09for improving human health are enormous thank you


0:21单晶体管，我们现在可以适合在一个十亿，而且说得那么一台电脑 0:35整个房间的大小，现在适合你的口袋里，而且使 0:41事情像智能手机和Fitbit比GPS跟踪设备，你发明 0:46可以说未来 0:47小作为一名工程师，并在这个新的球衣亚洲革命的启发 0:53电脑作为一名医生，我什么小型化可以做乐观 0:59人类的健康我不知道我们是否可以用它通过减少生活中的数

1:06世界上增长最快的疾病，由于一个 1:10野营，当我说什么大多数人听到我说，我们正在努力固化 1:15癌症和我们，但事实证明，有一个绝佳的机会 1:21保存在世界各地通过生活癌症的早期发现和预防 1:26癌症死亡的三分之二是完全可以预防的使用措施我们已经 1:31知道今天他们包括疫苗清洗，当然戒烟 1:38但即使使用最好的工具和技术，我们有我们提供 1:43找不到某些肿瘤至十年之久，他们已经开始成长后，当他们 1:48是约1500万癌细胞强劲，因此，如果我们有更好的技术， 1:54测试最致命的癌症深度年初的时候他们只是 1:58入门和可能 1:59移动，而愿景是，我们可以看到更多的活着，让我告诉你如何

2:04许多树木亚洲我让我们有这是你会发现在一个显微镜 2:09标准病理实验室，这将被用于检查它组织标本 2:13像活检报告，而该人在寻找这个$ 7,000名镜会 2:19与在如何发现多年的专门培训病理学家 2:23癌细胞现在比较，这，这是从我的同事的图像在 2:28莱斯大学的丽贝卡·理查兹季度，她的娱乐约翰是个 2:32微型显微镜，使其上的光纤和一个的端 2:38 $ 10部分是现在的，而不是从采取样本是什么意思 2:43患者在显微镜你可以把显微镜给病人，然后 2:49而不是依靠一个专家看照片是她和她的团队 2:53做的是把培养计算机自动评分与健康 2:57癌组织所以治疗决定可能会在一瞬间就做出现在这个

3:02是因为他们发现了什么重要的是，即使他们拥有移动 3:06筛选卡车就往社区和农村社区， 3:10执行宫颈检查和取样，并将其发送到实验室的天后 3:15当女性得到所谓的异常检测结果，并要求进来 3:19充分一半不露面，只是因为他们现在不能承受之旅 3:24随着新的光纤显微镜和计算机自动打分，他们已经 3:28能够创建一个综合的诊断和治疗比这人可以走出去 3:34进社区 3:35作出诊断，并提供在当下治疗，没有人已经失去了 3:40遵循所以这就是如何小型化可能挽救生命的一个例子，现在作为 3:46我们认为这是工程师在直小型化你讲一件大事 3:50你做了一点，但我告诉你之前，它是电脑 3:54改变了我们的生活完全成了一个足够小的为我们带他们 3:58无所不在，所以又有什么样子的变革相当于

4:03像癌症检测，如果我们有一个探测器，这是这么慢 4:09商场但它可以穿越你的身体，我可以全部找到肿瘤 4:13本身它可以发送信号到外面的世界，但我很喜欢一点点 4:19科幻实际上纳米技术使我们能够做到这一点娜娜 4:25技术使我们能够缩小构成探测器从零件 4:30人的头发丝宽度这是一个几百微米的生活小一千倍 4:35一个几百纳米，并且具有在那个链接，即可产生深远的影响 4:40我们所说的纳米级材料真正改变它们的属性，所以你 4:45金象看起来你的首饰黄金可以采取一种很常见的材料，如果你 4:50磨它分解成灰尘进入纳米粒子，它实际上看起来是红色的你 4:56可以采取更奇特的材料，如镉这个大黑水晶

5:01硒如果你让纳米晶体出这种物质，并把它们放在液体 5:07照我的时候，他们发光，他们焕发蓝，绿，黄橙红色视 5:15只有靠50可您在宏观世界想象的对象一样，它 5:22会像所有的牛仔裤在归仁维生素都是由棉和 5:28他们焕发不同的颜色，只是因为他们是不同的 5:31野生右好了，所以它不只是在改变材料的颜色 5:38纳米盖尔就那么让我感兴趣的是，他们的方式出行内部 5:44你的身体也改变，这里有一个小的电影，向您展示我需要什么 5:48这是在体内和周围的血管的血管是肿瘤确定 5:54我们要注入纳米粒子在血管中，看它们如何 5:58从血液进入肿瘤旅行，现在事实证明，血液

6:04许多肿瘤的血管是漏水等纳米粒子能泄漏是否 6:09或者他们不泄漏到宾夕法尼亚 6:11他们一边所以在这种形象你看到的是，较小的蓝色百 6:17纳米粒子可以泄露出更大的读取500纳米 6:22颗粒留下，这意味着作为一名工程师 6:27根据我大还是小制作的材料，我可以看到它在你的 6:33眼睛是我们要去尝试利用做出敏锐的洞察力的一种 6:38更好的癌症检测仪在我的实验室最近我们也的确让探测器是如此 6:43小，它可以在体内循环寻找肿瘤我们设计这个 6:48检测器监听肿瘤浸润化学信号的乐团是 6:54肿瘤需要传播的肿瘤扩散在它的组织出 6:59出生他们让化学物质称为酶而是两个两个的脚手架

7:04西装，我们在设计检测到这些酶之一，我被激活 7:12可在一小时和工程我们进行紧固的化学反应 7:17称它是一千达到你放大的一种形式，它通常会 7:21做技术的超敏感的，所以我们做了一个超敏感的癌症 7:26探测器确定，所以疯狂的意大利只是我们如何得到这个信号，这是在肿瘤 7:31到外面的世界里，我们可以检测到它，我们要使用另一个 7:37纳米生物学方面和具有与肾脏的肾脏做 7:42过滤和它的工作是从血液中过滤掉垃圾，并把它放入 7:47尿事实证明，肾脏是一个尺寸相关滤波，所以当这部电影 7:53你的意思是，小的5纳米粒子可以伸到 7:58尿液和一切较大保留在血液

8:02确定，所以，让我们把这三个概念在一起，告诉你它是如何工作 8:07我们所做的就是让我们注入了几百纳米的癌症检测仪 8:12在血液中它漏出到肿瘤 8:16通过酶在肿瘤活性和信号被释放足够小 8:22得到过滤掉由肾脏进入尿液尿它在中 8:28外面的世界，我们可以检测到它 8:30确定，所以还有最后一个挑战，我们如何检测尿液，如果在信号 8:35它是如此的渺小所以事实证明，这些信号都只是分子和他们 8:40我们工程师而不是分子完全合成的分子，该 8:45肾脏通常从今年放什么意思是，我们可以设计 8:48他们通过所选择的工具，可以读出这样的例子，如果我们使分子 8:54有一个独特的数学运算我们可​​以称之为看中敏感的仪器检测到它们 8:58相反，如果我们的东西感兴趣质谱仪说的很

9:02便携和便宜，我们可以设计出被困的东西分子 9:07喜欢像一个家庭怀孕测试纸的选择工程师是由我们和它 9:13取决于我们心目中现在感兴趣的应用程序 9:16便携性和我们做的东西像纸原来有一个全新的 9:20格式的世界变得更加美好不断出现在人们诊断这一新的领域，我们 9:26必须从选择 9:27确定，所以我们要去的时候我会告诉你下一步是我作为一个终身的角度 9:35研究员，它代表着一个梦想我有我不能说这是一个承诺，但它 9:41是一个梦想，我想大家都应该有梦想，甚至，也许特别是 9:46当我打算向你描述癌症研究人员正是我希望会 9:50我的技术，什么我的团队发生，我将奉献我们的心脏和 9:55灵魂进入试图使现实中我的梦想，要在一天之内，而不是

10:04用于结肠镜筛查乳房X光为一个子宫颈抹片昂贵的设施 10:09涂抹你得到一个店等待一个小时，做一次尿检在纸条 10:19我想，这可能不需要稳定的电力，即使发生 10:22或在房间里的医疗专家，也许他们会远离和 10:27只能通过智能手机上的图像，我希望这意味着连接 10:32我们可以发现肿瘤更快超过10年，他们已经开始成长后， 10:37急躁的所有世界各地的各行各业，这将导致 10:43早期治疗，我们可以更加节省活着比我们今天 10:47通过早期检测好了，所以我知道这听起​​来像一个梦，但实际上 10:53我们已经在我的生活取得了令人难以置信的进步在实验室已经在那里这 10:57技术正在对煤在卵巢癌和肺癌的检测和

11:03那么接下来的步骤是，试图把这个给患者这样的事情，我们有 11:06做我们的生产厂家很多，这些检测器中的规模，我们必须展现自己 11:12安全用于人类，当然，它工作以便使该使用 11:16发生 11:17我们已经组建了一个专门从翻译他们的科技团队 11:22实验室病人怎么样让你的权力小型化的意识， 11:28药我只是想结束在这一思想对我们的世界是 11:34你经常听到人们谈论它如何是一个小世界我们的世界 11:37越来越更小，更通过虚拟会话目前互联的话，我们 11:42有他们在其他任何时间 11:44时间在人类历史对我来说这是一个小世界，但以不同的方式 11:50未来是小这是一个世界，小型化和药能来 11:55一起来帮助我们理解监控和治疗人体分子 12:02谈话在最微小的技能，并在这个小世界机会 12:09为改善人类的健康是巨大的谢谢