TED Talks Live
Sangeeta Bhatia: This tiny particle could roam your body to find tumors
桑吉塔．巴蒂亞: 這微小粒子能在你身上漫遊找到腫瘤
Filmed:
Readability: 4.4
905,949 views
如果可以在惡性腫瘤傷害我們的數年前找到它們，而且不必使用昂貴的篩檢設備或甚至穩定的電流，這樣會如何呢？身兼醫師、生物工程師、企業家的桑吉塔．巴蒂亞（Sangeeta Bhatia ）領導了一個多重領域的實驗室，尋找新穎的方法來了解、診斷並治療人類的疾病。她的目標：她要讓因癌症死亡中三分之二的病人是可預防的。她以異常清楚的方式，分析複雜的奈米粒子科學，並分享了她對能挽救數百萬生命完全嶄新偵測癌症的檢查的夢想。
Sangeeta Bhatia - Physician, bioengineer and entrepreneur
Sangeeta Bhatia is a cancer researcher, MIT professor and biotech entrepreneur who works to adapt technologies developed in the computer industry for medical innovation. Full bio
Sangeeta Bhatia is a cancer researcher, MIT professor and biotech entrepreneur who works to adapt technologies developed in the computer industry for medical innovation. Full bio
Double-click the English transcript below to play the video.
00:12
In the space that used
to house one transistor,
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
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。
你可能會說，未來的東西會是小的。
00:26
You might say the future is small.
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身為一位工程師，
00:29
As an engineer,
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我被這個電腦的
微型化革命所啟發。
微型化革命所啟發。
00:30
I'm inspired by this miniaturization
revolution in computers.
revolution in computers.
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而身為一位醫師，
00:34
As a physician,
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00:36
I wonder whether we could use it
to reduce the number of lives lost
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:
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。
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.
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。
我們是研究癌症治療的。
的確是！
00:52
And we are.
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但事實上，
00:53
But it turns out
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00:55
that there's an incredible
opportunity to save lives
opportunity to save lives
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有一個不可思議的機會
可以拯救生命，
可以拯救生命，
00:57
through the early detection
and prevention of cancer.
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
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 ，
超過 2/3 是可預防的 ，
01:07
using methods that we already
have in hand today.
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,
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，
最好的工具與科技，
某些腫瘤要開始成長十年後
才能被偵測出來，
才能被偵測出來，
01:19
some tumors can't be detected
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01:22
until 10 years after
they've started growing,
they've started growing,
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那時的癌細胞已多達 5 千萬個了。
01:25
when they are 50 million
cancer cells strong.
cancer cells strong.
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01:30
What if we had better technologies
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要是我們有更好的科技，
可以更早偵測到更多這些致命的癌症，
01:31
to detect some of these more
deadly cancers sooner,
deadly cancers sooner,
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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？
讓我向各位說明
微型化科技將如何讓我們做到。
微型化科技將如何讓我們做到。
01:38
Let me tell you about how
miniaturization might get us there.
miniaturization might get us there.
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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,
for looking at a tissue specimen,
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病理學家用它來觀察組織的樣本，
例如活體切片或子宮頸抹片檢查。
01:49
like a biopsy or a pap smear.
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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
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,
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
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
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
就是把顯微鏡縮小成為一個
價值十元的零件，
02:08
into this $10 part,
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02:10
and it fits on the end
of an optical fiber.
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
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，
而是你可以把顯微鏡放到病人體內。
02:19
you can bring the microscope
to the patient.
to the patient.
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02:22
And then, instead of requiring
a specialist to look at the images,
a specialist to look at the images,
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並且，不需要專家來檢視影像，
你可以訓練電腦區分
正常細胞與癌症細胞。
正常細胞與癌症細胞。
02:26
you can train the computer to score
normal versus cancerous cells.
normal versus cancerous cells.
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這很重要，
02:32
Now this is important,
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02:33
because what they found
working in rural communities,
working in rural communities,
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因為他們發現在郊區工作，
即使有一台行動篩檢箱型車，
02:36
is that even when they have
a mobile screening van
a mobile screening van
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02:39
that can go out into the community
and perform exams
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,
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
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，
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.
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。
因為付不起旅費。
02:57
With the integrated microscope
and computer analysis,
and computer analysis,
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藉由整合顯微鏡與電腦分析，
麗貝卡和她的同事
已經可以做出一台
已經可以做出一台
03:01
Rebecca and her colleagues
have been able to create a van
have been able to create a van
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03:04
that has both a diagnostic setup
and a treatment setup.
and a treatment setup.
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同時具有診斷與治療設施的廂型車。
意思就是，他們可以直接在現場
03:07
And what that means
is that they can do a diagnosis
is that they can do a diagnosis
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03:10
and perform therapy on the spot,
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做診斷與治療，
這樣就沒人會錯過追蹤了。
03:13
so no one is lost to follow up.
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03:15
That's just one example of how
miniaturization can save lives.
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。
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.
as straight-up miniaturization.
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我們認為這就是微型化，
你把一個大的東西變小了。
03:24
You took a big thing
and you made it little.
and you made it little.
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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
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.
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。
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?
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？
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，
它小到可以在你的體內循環，
03:43
that was so small that it could
circulate in your body,
circulate in your body,
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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.
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.
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。
已經可以讓我們做到了。
03:59
Nanotechnology allows us to shrink
the parts that make up the detector
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
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
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。
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,
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.
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 --
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 ──
像是硒化鎘 ──
一個大而黑的晶體，
04:34
forms a big, black crystal --
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04:37
if you make nanocrystals
out of this material
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，
並以光線照射它
04:41
and you shine light on it,
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04:43
they glow.
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它們會發光。
04:44
And they glow blue, green,
yellow, orange, red,
yellow, orange, red,
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它們會發出藍色、綠色、
黃色、橘色、紅色的光，
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?
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？
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,
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，
全都是棉製的牛仔褲，
會依它們的尺寸大小
而有不同的顏色。
而有不同的顏色。
05:03
but they are different colors
depending only on their size.
depending only on their size.
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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
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；
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.
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。
運行方式也會改變。
而我們將運用這種觀察方式
05:23
And this is the kind of observation
that we're going to use
that we're going to use
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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
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.
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。
血流中進到腫瘤裡面。
05:43
Now it turns out that the blood vessels
of many tumors are leaky,
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，
許多腫瘤的血管有漏洞，
05:47
and so nanoparticles can leak out
from the bloodstream into the tumor.
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.
depends on their size.
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它們是否會漏出去
取決於它們的大小。
取決於它們的大小。
05:56
So in this image,
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在這影像
較小、100奈米的
藍色奈米粒子正在漏出去，
藍色奈米粒子正在漏出去，
05:57
the smaller, hundred-nanometer,
blue nanoparticles are leaking out,
blue nanoparticles are leaking out,
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06:01
and the larger, 500-nanometer,
red nanoparticles
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,
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
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，
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.
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:
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.
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。
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,
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，
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，
稱為「酵素」的化學物質，
06:42
to chew through
the scaffolding of tissues.
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.
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，
可被腫瘤酵素活化，
06:51
One enzyme can activate a thousand
of these chemical reactions in an hour.
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。
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
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，
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.
cancer detector.
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所以我們製造出一種
超靈敏的癌症偵測器，
超靈敏的癌症偵測器，
07:09
OK, but how do I get this activated
signal to the outside world,
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,
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，
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.
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，
從血液濾出並排入尿液，
其實腎臟所過濾的物質
07:29
It turns out that what the kidney filters
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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
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,
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.
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,
cancer detector,
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好，如果我做了一個
100 奈米的癌症偵測器，
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
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，
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
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.
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。
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，
我要如何偵測呢？
08:16
so how do I detect it?
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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.
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
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，
我們可以設計它們，
讓它與我們選擇的工具完全相容。
08:26
so they are compatible
with our tool of choice.
with our tool of choice.
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08:30
If we want to use a really
sensitive, fancy instrument
sensitive, fancy instrument
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如果我們要用一種
相當靈敏的昂貴設備 ──
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.
with a unique mass.
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那麼我們會製造
一種特定質量的分子。
一種特定質量的分子。
或許我們想讓它
不那麼昂貴且方便攜帶，
不那麼昂貴且方便攜帶，
08:38
Or maybe we want make something
that's more inexpensive and portable.
that's more inexpensive and portable.
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08:42
Then we make molecules
that we can trap on paper,
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，
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
world of paper tests
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事實上，現在有很多的試紙測試方法，
已廣泛應用在「試紙診斷」領域了。
08:50
that are becoming available
in a field called paper diagnostics.
in a field called paper diagnostics.
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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？
接下來我要告訴各位的是
08:58
What I'm going to tell you next,
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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。
我認為我們都必須有夢想
來讓我們向前邁進，
來讓我們向前邁進，
09:08
But I think we all have to have dreams
to keep us pushing forward,
to keep us pushing forward,
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09:11
even -- and maybe especially --
cancer researchers.
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,
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，
我的技術將來會有何進展，
09:19
that my team and I will put
our hearts and souls
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
an expensive screening facility
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大家不用再使用昂貴的篩檢設備
來做大腸鏡檢查
09:33
to get a colonoscopy,
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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。
我想像這甚至
09:45
I imagine that this could even happen
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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。
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.
on a smartphone.
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僅用智能手機連結影像即可。
我知道這聽起來像是個夢想，
09:58
Now I know this sounds like a dream,
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10:00
but in the lab we already
have this working in mice,
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，
我們已經用在老鼠身上了，
10:03
where it works better
than existing methods
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。
這比現行方法更有用。
10:05
for the detection of lung,
colon and ovarian cancer.
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
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。
我們就可以偵測到。
10:18
sooner than 10 years
after they've started growing,
after they've started growing,
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在各行各業、世界各地的人都能受惠，
10:21
in all walks of life,
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10:23
all around the globe,
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10:25
and that this would lead
to earlier treatments,
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,
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。
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！
（掌聲）
10:34
(Applause)
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ABOUT THE SPEAKER
Sangeeta Bhatia - Physician, bioengineer and entrepreneurSangeeta Bhatia is a cancer researcher, MIT professor and biotech entrepreneur who works to adapt technologies developed in the computer industry for medical innovation.
Why you should listen
Trained as both a physician and engineer at Harvard, MIT, and Brown University, Sangeeta Bhatia leverages 'tiny technologies' of miniaturization to yield inventions with new applications in tissue regeneration, stem cell differentiation, medical diagnostics, predictive toxicology and drug delivery. She and her trainees have launched more than 10 biotechnology companies to improve human health.
Bhatia has received many honors including the Lemelson-MIT Prize, known as the 'Oscar for inventors,' and the Heinz Medal for groundbreaking inventions and advocacy for women in STEM fields. She is a Howard Hughes Medical Institute Investigator, the Director of the Marble Center for Cancer Nanomedicine at the Koch Institute for Integrative Cancer Research and an elected member of the National Academy of Engineering, the American Academy of Arts and Science and Brown University's Board of Trustees.
Sangeeta Bhatia | Speaker | TED.com