TEDGlobal 2014
Jorge Soto: The future of early cancer detection?
豪尔赫·索托: 早期癌症诊断的未来？
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在众多技术专家和科学家的帮助下，豪尔赫·索托正在开发一种简单的、无侵入性的，与“开源”的测试来诊断早期癌症的各种信号。在 TEDGlobal 2014 的演讲台上，他第一次展示了一种移动平台的工作原型。
Jorge Soto - Cancer technologist
Jorge Soto is helping develop a simple, noninvasive test that identifies cancer. Full bio
Jorge Soto is helping develop a simple, noninvasive test that identifies cancer. Full bio
Double-click the English transcript below to play the video.
00:12
Almost a year ago,
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差不多一年以前
00:14
my aunt started suffering back pains.
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我的一个阿姨开始觉得背部疼痛
00:16
She went to see the doctor
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她去医院检查
00:18
and they told her it was a normal injury
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医生们告诉她，
对于过去30年从事网球运动的人来说
对于过去30年从事网球运动的人来说
00:20
for someone who had been playing tennis
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00:22
for almost 30 years.
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这只是普通伤痛
00:24
They recommended that she do some therapy,
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医生们建议她进行一些治疗
00:26
but after a while she wasn't feeling better,
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但是过了一阵她并没有感觉有任何好转
00:29
so the doctors decided to do further tests.
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所以医生们决定进一步的做一些检查
00:32
They did an x-ray
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他们做了X光
00:33
and discovered an injury in her lungs,
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然后找到了她肺部的一个伤口
00:35
and at the time they thought that the injury
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当时医生们仍然觉得那个伤口
00:37
was a strain in the muscles and tendons
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是她肋骨之间的
00:38
between her ribs,
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肌肉或者肌腱的拉伤
00:39
but after a few weeks of treatment,
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不过，经过好几周的治疗
00:41
again her health wasn't getting any better.
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伤痛仍然没有好转
00:45
So finally, they decided to do a biopsy,
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最后，医生们决定做一次活体组织检验
00:49
and two weeks later,
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于是，两周之后
00:50
the results of the biopsy came back.
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活体组织检验的结果出来了
00:53
It was stage 3 lung cancer.
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结果是肺癌，已经到了第三期
00:58
Her lifestyle was almost free of risk.
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她的生活方式非常健康
01:01
She never smoked a cigarette,
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她从来不抽烟
01:02
she never drank alcohol,
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从来不喝酒
01:04
and she had been playing sports
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体育事业占据了她几乎半生
01:05
for almost half her life.
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01:07
Perhaps, that is why it took them almost six months
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也许，这正是医生们花了六个月的时间
01:11
to get her properly diagnosed.
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才对她做出了正确诊断的原因吧
01:14
My story might be, unfortunately,
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不幸的是，我的故事可能
01:16
familiar to most of you.
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让你们都觉得熟悉
01:18
One out of three people sitting in this audience
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在座的三分之一的听众们
01:21
will be diagnosed with some type of cancer,
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都可能被诊断为某种癌症
01:24
and one out of four
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并且四分之一的人
01:25
will die because of it.
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会因此而死亡
01:28
Not only did that cancer diagnosis
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改变我们整个家庭生活的，
01:30
change the life of our family,
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不仅是被诊断为癌症的结果，
01:32
but that process of going
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还有那些反复做各种新检测的过程，
01:34
back and forth with new tests,
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01:37
different doctors describing symptoms,
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以及不停地向不同的医生描述症状
01:39
discarding diseases over and over,
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又反反复复的推翻之前诊断的过程，
01:42
was stressful and frustrating,
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这些都让人承受着巨大的压力
尤其让阿姨十分沮丧
01:44
especially for my aunt.
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01:46
And that is the way cancer diagnosis has been done
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但是，从有历史以来
01:49
since the beginning of history.
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癌症的诊断就是以这种方式进行的
01:51
We have 21st-century medical treatments and drugs
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我们用21世纪的医疗设备和药物
01:54
to treat cancer,
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来治疗癌症
01:56
but we still have 20th-century procedures
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却还在用20世纪的流程和手续来诊断癌症
01:58
and processes for diagnosis, if any.
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如果这能被称作流程的话
02:02
Today, most of us have to wait for symptoms
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今天，大多数诊断都依赖于症状的表现
02:05
to indicate that something is wrong.
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02:07
Today, the majority of people still don't have access
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今天，我们中的绝大多数仍然没有
02:10
to early cancer detection methods,
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诊断早期癌症的方法
02:12
even though we know
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即便我们知道
02:14
that catching cancer early
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癌症的早期发现
02:16
is basically the closest thing we have
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基本上是我们所能做的
02:17
to a silver bullet cure against it.
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最好的治愈癌症的良方
02:21
We know that we can change this in our lifetime,
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我们知道我们可以
在我们有生之年改变这种状况
在我们有生之年改变这种状况
02:23
and that is why my team and I
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这就是我和我的团队
02:25
have decided to begin this journey,
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决定开始这一段旅程的原因
02:27
this journey to try to make cancer detection
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这一段旅程的目的就是尝试
02:29
at the early stages
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癌症的早期诊断
02:31
and monitoring the appropriate
response at the molecular level
response at the molecular level
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并且在分子的维度监控适当的反应
02:34
easier, cheaper, smarter
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更简单、更便宜、更智慧
02:38
and more accessible than ever before.
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并且前所未有的更有可行性
02:42
The context, of course,
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当然，这事情的背景是
02:43
is that we're living at a time
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我们生活的现在这个时代
02:45
where technology is disrupting our present
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科学技术正在
02:46
at exponential rates,
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以惊人的速度发展着
02:48
and the biological realm is no exception.
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生物领域也没有例外
02:51
It is said today that biotech is advancing
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据说现在生物技术的发展的速度
02:53
at least six times faster than the growth rate
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比计算机处理能力的增长
02:55
of the processing power of computers.
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还要至少快六倍
02:58
But progress in biotech
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但是生物技术领域的进步
02:59
is not only being accelerated,
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并不仅仅是速度的增长
03:01
it is also being democratized.
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而且也更加的大众化
03:03
Just as personal computers or the Internet
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就像个人电脑或互联网
03:06
or smartphones leveled the playing field
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或智能手机拓宽了商业、政治和教育
03:08
for entrepreneurship, politics or education,
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的舞台一样
03:11
recent advances have leveled it
up for biotech progress as well,
up for biotech progress as well,
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最近的科技发展同样更新了
生物技术的发展水平
生物技术的发展水平
03:15
and that is allowing
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这让我们这样的
03:16
multidisciplinary teams like ours
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来自不同领域的人组成的团队
03:18
to try to tackle and look at these problems
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可以使用一些新的途径
03:21
with new approaches.
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去尝试解决和攻克一些难题
03:23
We are a team of scientists and technologists
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我们的团队由来自智利、巴拿马
03:26
from Chile, Panama,
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墨西哥、以色列和希腊的
03:29
Mexico, Israel and Greece,
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科学家和技术人员组成
03:32
and based on recent scientific discoveries,
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在最近的科学发现的基础上
03:35
we believe that we have found
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我们相信我们已经找到了
03:36
a reliable and accurate way
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一种可靠和准确的方式
03:39
of detecting several types of cancer
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在很早的阶段，通过血液样本检测来
03:41
at the very early stages through a blood sample.
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诊断几种癌症
03:44
We do it by detecting a set of very small molecules
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我们通过检测一组在我们血液中自由流动的
03:47
that circulate freely in our blood
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细胞分子来做诊断
03:48
called microRNAs.
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它们被称为微型RNA
03:51
To explain what microRNAs are
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为了解释微型RNA是什么
03:53
and their important role in cancer,
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以及它们在癌症当中扮演的重要角色
03:56
I need to start with proteins,
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我需要从蛋白质开始
03:57
because when cancer is present in our body,
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因为当我们的身体中出现癌症时
04:00
protein modification is observed
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我们观察到了所有的癌细胞都在进行
04:01
in all cancerous cells.
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“蛋白质的修饰”
04:03
As you might know,
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你可能知道
04:04
proteins are large biological molecules
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蛋白质是一种大型的生物分子
04:06
that perform different functions within our body,
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蛋白质在我们的身体里面执行不同的功能
04:09
like catalyzing metabolic reactions
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比如促进新陈代谢反应
04:11
or responding to stimuli
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或对外部刺激做出反应
04:13
or replicating DNA,
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或者复制DNA
04:14
but before a protein is expressed or produced,
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但是，在蛋白质被生成或表达之前
04:17
relevant parts of its genetic code
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它的DNA中的
04:19
present in the DNA
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基因编码的相应部分
04:21
are copied into the messenger RNA,
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也会被复制到信使RNA中
04:25
so this messenger RNA
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因此，这个信使RNA
04:27
has instructions on how to build a specific protein,
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掌握了如何生成一种特定蛋白质的指令
04:31
and potentially it can build hundreds of proteins,
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实际上，信使RNA可以生成好几百中不同的蛋白质
04:33
but the one that tells them when to build them
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但是告诉它什么时候生成
04:36
and how many to build
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以及生成多少的
04:38
are microRNAs.
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是微型RNA
04:41
So microRNAs are small molecules
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微型RNA是一种
04:42
that regulate gene expression.
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规范基因表达的小分子
04:45
Unlike DNA, which is mainly fixed,
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和基本固定的DNA不一样
04:47
microRNAs can vary depending on internal
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微型RNA根据不同时间的内部和外部环境因素
04:49
and environmental conditions at any given time,
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可能各不相同
04:52
telling us which genes are actively
expressed at that particular moment.
expressed at that particular moment.
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它告诉我们在一个特定时间，哪些基因是主动表达的
04:55
And that is what makes microRNAs
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这就是微型RNA
04:57
such a promising biomarker for cancer,
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这真是一个很好的癌症的生物标记
04:59
because as you know,
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因为，你应该知道的
05:01
cancer is a disease of altered gene expression.
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癌症是一种基因表达改变的疾病
05:05
It is the uncontrolled regulation of genes.
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它是基因规则不受控制的结果
05:08
Another important thing to consider
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另一件值得考虑的重要的事情是
05:10
is that no two cancers are the same,
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没有任何两种癌症是一模一样的
05:12
but at the microRNA level, there are patterns.
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不过，在微型RNA的角度，有一些规律可循
05:15
Several scientific studies have shown
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一些科学研究表明
05:18
that abnormal microRNA expression levels
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不正常的微型RNA表达的等级
05:21
varies and creates a unique, specific pattern
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根据不同的癌症
05:24
for each type of cancer,
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有不同的、独特的模型
05:26
even at the early stages,
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即便是在早期
05:27
reflecting the progression of the disease,
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可以反映疾病的发展状况
05:29
and whether it's responding to medication
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另外，在对判断治疗是否有效
05:31
or in remission,
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或疾病是否有所缓解的判断上
05:32
making microRNAs a perfect,
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微型RNA绝对是一个完美的
05:35
highly sensitive biomarker.
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高度敏感的生物标记
05:38
However, the problem with microRNAs
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不过，微型RNA的问题在于
05:41
is that we cannot use existing DNA-based technology
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现有的基于DNA的科技
05:43
to detect them in a reliable way,
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无法做到可靠的识别它们
05:46
because they are very short sequences of nucleotides,
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因为它们是一串非常短序列的核苷酸
05:49
much smaller than DNA.
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比DNA小得多
05:51
And also, all microRNAs are
very similar to each other,
very similar to each other,
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也正因为如此，所有的微型RNA都看起来差不多
05:54
with just tiny differences.
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可能仅仅有很细微的差别
05:56
So imagine trying to differentiate two molecules,
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所以，想象一下，尝试分辨
05:59
extremely similar, extremely small.
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两个极其相似，又极其微小的分子
06:02
We believe that we have found a way to do so,
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我们相信我们找到一个方法
06:05
and this is the first time that we've shown it in public.
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这是我们第一次公开的展示
06:07
Let me do a demonstration.
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请让我们做一个示范
06:10
Imagine that next time you go to your doctor
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想象一下，下一次你去找医生的时候
06:12
and do your next standard blood test,
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做常规的血液测试
06:14
a lab technician extracts a total RNA,
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实验室技术人员分离出一个完整的RNA
06:17
which is quite simple today,
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这其实在现在非常简单
06:19
and puts it in a standard
96-well plate like this one.
96-well plate like this one.
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然后把它放到到一个标准的96孔板--就像这个一样
06:21
Each well of these plates
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我们给这个板的每一个孔都分配
06:23
has specific biochemistry that we assign,
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一个特定的生化指标
06:26
that is looking for a specific microRNA,
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用来寻找一个特定的微型RNA
06:28
acting like a trap that closes
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就好像一个陷阱
06:30
only when the microRNA is present in the sample,
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仅在特定的微型RNA在样本里出现时才会启动
06:32
and when it does, it will shine with green color.
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并且陷阱启动的时候，它会变成绿色
06:35
To run the reaction,
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为了做这个测试
06:36
you put the plate inside a device like this one,
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你将这个板放进一个设备--好像这一个
06:40
and then you can put your smartphone on top of it.
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之后你可以把你的智能手机放在它上面
06:43
If we can have a camera here
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如果在这里我们可以有一个摄像头
06:46
so you can see my screen.
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你就可以看到我的视野了
06:49
A smartphone is a connected computer
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智能手机是一个联网的计算机
06:51
and it's also a camera,
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同时它也是一个相机
06:53
good enough for our purpose.
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这已经足够帮助我们了
06:59
The smartphone is taking pictures,
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智能手机在这里不停的照相
07:01
and when the reaction is over,
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当这里的反应结束
07:02
it will send the pictures
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它会把这些照片
07:03
to our online database for processing
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发送到我们的网上处理中心
07:06
and interpretation.
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进行处理和翻译
07:07
This entire process lasts around 60 minutes,
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整个过程大概需要60分钟
07:10
but when the process is over,
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不过当这个过程结束之时
07:12
wells that shine are matched
with the specific microRNAs
with the specific microRNAs
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变绿的孔是和特定的微型RNA相匹配的
07:15
and analyzed in terms of how much and how fast
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并且已经分析了它们变绿的
07:17
they shine.
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数量和速度
07:19
And then, when this entire process is over,
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之后，整个过程结束之后
07:23
this is what happens.
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这是将要发生的
07:25
This chart is showing the specific microRNAs
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这一张图表展示了
07:28
present in this sample
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这一个样本里存在的特定微型RNA
07:29
and how they reacted over time.
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以及它们如何随时间进行反应
07:32
Then, if we take this specific pattern of microRNA
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然后，如果我们采集这个人的样本中
07:34
of this person's samples
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微型RNA的特定模型
07:36
and compare it with existing scientific documentation
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然后和现有的与微型RNA模型有关的
07:39
that correlates microRNA patterns
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科学资料进行对比
07:41
with a specific presence of a disease,
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如果有一种特定的疾病
07:46
this is how pancreatic cancer looks like.
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这就是胰腺癌看起来的样子
07:49
This inside is a real sample
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这里面的是一个真正的样本
07:52
where we just detected pancreatic cancer.
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在里面我们诊断了胰腺癌
07:55
(Applause)
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（掌声）
08:04
Another important aspect of this approach
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关于这个方法的另外一个重要的方面是
08:06
is the gathering and mining of data in the cloud,
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收集和挖掘云端的数据
08:08
so we can get results in real time
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我们才能实时的得到结果
08:10
and analyze them with our contextual information.
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才能够结合我们掌握的信息进行分析
08:13
If we want to better understand
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如果我们希望更好的
08:15
and decode diseases like cancer,
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理解和解决癌症这样的疾病
08:17
we need to stop treating them
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我们就不能把它们当成
08:18
as acute, isolated episodes,
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急性的、独立的片段
08:20
and consider and measure everything
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我们要考虑和测试一切
08:22
that affects our health on a permanent basis.
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可能永久的影响我们的健康的因素
08:27
This entire platform is a working prototype.
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这整个平台是一个工作原型
08:31
It uses state-of-the-art molecular biology,
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它使用当前最新的分子生物技术
08:34
a low-cost, 3D-printed device,
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一种低成本的3D打印设备
08:37
and data science
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以及数据科学
08:39
to try to tackle one of humanity's
toughest challenges.
toughest challenges.
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来尝试攻克一个人类历史上最难的挑战
08:43
Since we believe early cancer detection
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我们相信早期的癌症诊断
08:45
should really be democratized,
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绝对应该被普及到大众
08:47
this entire solution costs at least 50 times less
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这一套完整的解决方案与
现有可行的方法相比
现有可行的方法相比
08:49
than current available methods,
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至少在成本上要便宜50倍
08:51
and we know that the community can help us
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我们还相信社区能帮助我们
08:53
accelerate this even more,
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进一步的加速这个方案的实施
08:54
so we're making the design of the device
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因此我们把这个设备的设计
08:56
open-source.
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进行了开源
08:59
(Applause)
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（掌声）
09:07
Let me say very clearly
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让我非常明确的说一句
09:09
that we are at the very early stages,
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我们是在很初步的阶段
09:11
but so far, we have been able
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但是到目前为止
09:13
to successfully identify the microRNA pattern
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我们已经成功的识别出了
09:15
of pancreatic cancer, lung cancer,
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胰腺癌、肺癌、乳腺癌
09:19
breast cancer and hepatic cancer.
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和肝癌的微型RNA模型
09:22
And currently, we're doing a clinical trial
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现在，我们与德国癌症研究中心合作
09:25
in collaboration with the
German Cancer Research Center
German Cancer Research Center
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正在对200名女性
09:28
with 200 women for breast cancer.
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进行乳腺癌诊断的临床试验
09:31
(Applause)
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（掌声）
09:35
This is the single non-invasive,
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这是一种无侵入性
09:38
accurate and affordable test
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准确的，并且并不昂贵的测试
09:40
that has the potential to dramatically change
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而这个测试具有巨大的潜力
09:43
how cancer procedures and diagnostics
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它可能会极大的改变
09:44
have been done.
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癌症诊断和治疗的方法
09:46
Since we're looking for the microRNA patterns
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鉴于我们可以在任何特定时间
09:48
in your blood at any given time,
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在你的血液样本中寻找微型RNA模式
09:50
you don't need to know
which cancer you're looking for.
which cancer you're looking for.
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你不需要要求检查哪一种癌症
09:52
You don't need to have any symptoms.
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你也不必要一定有症状
09:55
You only need one milliliter of blood
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你只需要1毫升的血液
09:57
and a relatively simple array of tools.
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以及一组相对简单的工具
10:01
Today, cancer detection happens mainly
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如今，癌症的诊断
10:04
when symptoms appear.
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只会在症状显现的时候进行
10:06
That is, at stage 3 or 4,
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那基本就是第三阶段或者第四阶段了
10:08
and I believe that is too late.
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这已经太晚了
10:10
It is too expensive for our families.
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对我们的家庭来说，这代价太高
10:12
It is too expensive for humanity.
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对人类来说，这代价太高
10:15
We cannot lose the war against cancer.
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我们不能输掉对抗癌症的战争
10:18
It not only costs us billions of dollars,
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这场战争不仅仅消耗我们数亿美金
10:20
but it also costs us the people we love.
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它还会让我们付出失去我们所爱的人的代价
10:23
Today, my aunt, she's fighting bravely
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现在，我的阿姨正在勇敢的、以积极的心态
10:26
and going through this process
with a very positive attitude.
with a very positive attitude.
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和癌症做斗争
10:29
However, I want fights like this
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只不过，我希望这样的斗争
10:32
to become very rare.
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变得极为少见
10:33
I want to see the day
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我希望看到那一天
10:34
when cancer is treated easily
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癌症由于可以被常规的诊断出来
10:36
because it can be routinely diagnosed
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而使得其可以在早期
10:38
at the very early stages,
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被轻松的治愈
10:40
and I'm certain
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我相信
10:42
that in the very near future,
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这一天就快到来了
10:44
because of this
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因为它
10:45
and other breakthroughs that we are seeing
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以及其他的我们所看到的科技突破
10:46
every day in the life sciences,
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生命科学的每一天
10:48
the way we see cancer
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我们看待癌症的方式
10:50
will radically change.
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将会发生明显的变化
10:52
It will give us the chance of detecting it early,
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科技的发展让我们可以及早的诊断癌症
10:54
understanding it better,
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更好的了解癌症
10:56
and finding a cure.
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更好的找到治疗的方法
10:58
Thank you very much.
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非常感谢
11:00
(Applause)
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（掌声）
ABOUT THE SPEAKER
Jorge Soto - Cancer technologistJorge Soto is helping develop a simple, noninvasive test that identifies cancer.
Why you should listen
Last year, electrical engineer Jorge Soto co-founded mirOculus with a group of fellow Singularity University students to push forward the development of a bold new test for cancer -- one that functions by looking for microRNA in the bloodstream, which could point to the presence of different types of cancer at very early stages. It's early stages for the device as well, but initial trials are promising. The open source device debuted publicly at the TEDGlobal conference in 2014.
Soto is a graduate of both Tec de Monterrey and Singularity University. In September 2013, he returned to Mexico to help the President’s Office develop strategies and projects that encourage civic participation, transparency, accountability and innovation in Mexico, and improve the communication between citizens and their institutions.
More profile about the speakerSoto is a graduate of both Tec de Monterrey and Singularity University. In September 2013, he returned to Mexico to help the President’s Office develop strategies and projects that encourage civic participation, transparency, accountability and innovation in Mexico, and improve the communication between citizens and their institutions.
Jorge Soto | Speaker | TED.com