Almost a year ago, my aunt started suffering back pains. She went to see the doctor and they told her it was a normal injury for someone who had been playing tennis for almost 30 years. They recommended that she do some therapy, but after a while she wasn't feeling better, so the doctors decided to do further tests. They did an x-ray and discovered an injury in her lungs, and at the time they thought that the injury was a strain in the muscles and tendons between her ribs, but after a few weeks of treatment, again her health wasn't getting any better. So finally, they decided to do a biopsy, and two weeks later, the results of the biopsy came back. It was stage 3 lung cancer.
大概一年前 我阿姨開始受到背疼折磨 她去看了醫生 醫生說只是平常傷痛 就像一個打過三十年網球的人 會受的傷痛 醫生建議她去接受一些理療 但過了一段時間還是沒有好轉 於是醫生進行了進一步檢查 做完X光檢查後 發現她傷病在於肺部 那時醫生還以為病疼 只是肋骨間肌肉和肌腱 通常的拉傷 但是經過幾周的治療 阿姨的情況仍沒有好轉 最終,醫生決定進行組織切片 兩周後 切片檢查結果顯示為 肺癌第三期
Her lifestyle was almost free of risk. She never smoked a cigarette, she never drank alcohol, and she had been playing sports for almost half her life. Perhaps, that is why it took them almost six months to get her properly diagnosed.
阿姨的生活方式本是很健康的 她從不吸菸 也從不飲酒 她保持運動 幾乎從不間斷 也許,這也說明為什麼醫生幾乎六個月後 才給了她正確的診斷
My story might be, unfortunately, familiar to most of you. One out of three people sitting in this audience will be diagnosed with some type of cancer, and one out of four will die because of it. Not only did that cancer diagnosis change the life of our family, but that process of going back and forth with new tests, different doctors describing symptoms, discarding diseases over and over, was stressful and frustrating, especially for my aunt. And that is the way cancer diagnosis has been done since the beginning of history. We have 21st-century medical treatments and drugs to treat cancer, but we still have 20th-century procedures and processes for diagnosis, if any.
不幸的是,這個例子可能 很多人也經歷過 在座各位有三分之一的人 可能診斷出有某種類型的癌症 並且四分之一的人 可能因此喪生 不僅是癌症確診 會徹底改變一個家庭的生活 還有那個診斷的過程 反反覆覆,各種測試 與不同醫生描述病症 討論病情,一遍又一遍 這個過程伴隨著壓力和沮喪 我阿姨深受其苦 這種癌症診斷過程 從以前到現在都是如此 我們現在有 21 世紀的醫療技術和藥品 來治療癌症 然而,對於癌症來說, 我們仍在應用 20 世紀的診斷程序 和診斷過程
Today, most of us have to wait for symptoms to indicate that something is wrong. Today, the majority of people still don't have access to early cancer detection methods, even though we know that catching cancer early is basically the closest thing we have to a silver bullet cure against it. We know that we can change this in our lifetime, and that is why my team and I have decided to begin this journey, this journey to try to make cancer detection at the early stages and monitoring the appropriate response at the molecular level easier, cheaper, smarter and more accessible than ever before.
今天,我們大多數人還必須等待 出現某種症狀才意識到危險 今天,大多數人仍然不知道 早期癌症的檢測方法 即使我們已經明白 及早發現癌症 才是我們治癒癌症 的最有效方式 我和我的團隊堅信,在有生之年 我們能夠改變這種情況 於是我們開始了這一征程 致力於在癌症初級階段 就檢測到癌症 並在分子層面上 對相應的治療反應給予監控 使其更輕鬆,更廉價,更聰明 而且比以往更方便
The context, of course, is that we're living at a time where technology is disrupting our present at exponential rates, and the biological realm is no exception. It is said today that biotech is advancing at least six times faster than the growth rate of the processing power of computers. But progress in biotech is not only being accelerated, it is also being democratized. Just as personal computers or the Internet or smartphones leveled the playing field for entrepreneurship, politics or education, recent advances have leveled it up for biotech progress as well, and that is allowing multidisciplinary teams like ours to try to tackle and look at these problems with new approaches.
就在當下 我們所處的時代背景下 科技正在以指數級的速度 改變著我們當下的處境 生物領域也不例外 據說,現今生物科技的進步速度 至少六倍於 電腦處理速度的增長 然而,生物科技的進步 不僅是進步速度加快 而且變得更加大眾化 就像個人電腦和網路 或智慧型手機在商業、政治、教育領域 造成的扁平化影響一樣 現今的科技進步也在生物科技領域 開闢了一片新天地 這使得 像我們一樣的多學科團隊 能夠嘗試從一個新途徑來研究和解決 這些生物科技的課題
We are a team of scientists and technologists from Chile, Panama, Mexico, Israel and Greece, and based on recent scientific discoveries, we believe that we have found a reliable and accurate way of detecting several types of cancer at the very early stages through a blood sample. We do it by detecting a set of very small molecules that circulate freely in our blood called microRNAs.
我們團隊的科學家和工程師 來自智利、巴拿馬 墨西哥、以色列和希臘 基於最新的科學發現 相信我們已經發現了 一種可靠和準確的方式 在非常初期時檢測出若干種癌症 而這只需血液樣本就可以完成 我們的方法是,檢測一組小血液分子 該類血液分子在我們血液裡自由流動 我們稱之為:微 RNAs
To explain what microRNAs are and their important role in cancer, I need to start with proteins, because when cancer is present in our body, protein modification is observed in all cancerous cells. As you might know, proteins are large biological molecules that perform different functions within our body, like catalyzing metabolic reactions or responding to stimuli or replicating DNA, but before a protein is expressed or produced, relevant parts of its genetic code present in the DNA are copied into the messenger RNA, so this messenger RNA has instructions on how to build a specific protein, and potentially it can build hundreds of proteins, but the one that tells them when to build them and how many to build are microRNAs. So microRNAs are small molecules that regulate gene expression. Unlike DNA, which is mainly fixed, microRNAs can vary depending on internal and environmental conditions at any given time, telling us which genes are actively expressed at that particular moment. And that is what makes microRNAs such a promising biomarker for cancer, because as you know, cancer is a disease of altered gene expression. It is the uncontrolled regulation of genes. Another important thing to consider is that no two cancers are the same, but at the microRNA level, there are patterns. Several scientific studies have shown that abnormal microRNA expression levels varies and creates a unique, specific pattern for each type of cancer, even at the early stages, reflecting the progression of the disease, and whether it's responding to medication or in remission, making microRNAs a perfect, highly sensitive biomarker.
為了解釋什麼是微RNAs 及它在癌症檢測中的作用 我們從蛋白質開始說起 當癌症開始在我們身體裡出現 我們觀察到,在所有癌細胞中 蛋白質出現了改變 眾所周知 蛋白質是一種大型生物分子 在我們身體內承擔不同功能 例如,促進新陳代謝反應 對外部刺激發生反應 或是進行 DNA 複製 但是,在蛋白質表達或產出之前 存在於 DNA 中的 相關遺傳密碼 被複製到傳訊息的核糖核酸 (RNA) 中 這種傳訊息的核糖核酸 攜帶著指令來產生出特定一種蛋白質 雖然它隱含製造數百種蛋白質的訊息 但其中有一段訊息 能決定何時生產蛋白質 及生產多少 這部分就是微 RNAs 所以,微 RNAs 就是 可以調節基因表達的小型分子 與 DNA 攜帶固定訊息不同 微 RNAs 在任意時間 能根據內外環境不同而變化 它決定了哪種基因 在特定時刻被有效表達 這就是為什麼微 RNAs 有希望成為 癌症檢測的生物標記的原因 我們知道 癌症是一種基因表達變異產生的疾病 是基因調節的失控所致 另一個重要問題是 沒有任何兩種癌症是相同的 但在微 RNAs 層面上 是可以進行分類的 若干科學研究表明 異常微 RNAs 的表達 會產生不同而各自獨特的類型 對應各種不同類型的癌症 即使在癌症最初階段 微 RNAs 也能反應出病症的發展過程 以及藥物治療是否有效 或是否處於病症緩解中 這使得微 RNAs 成為一個極其有效 非常靈敏的生物標記
However, the problem with microRNAs is that we cannot use existing DNA-based technology to detect them in a reliable way, because they are very short sequences of nucleotides, much smaller than DNA. And also, all microRNAs are very similar to each other, with just tiny differences. So imagine trying to differentiate two molecules, extremely similar, extremely small.
可是,微 RNAs 的困難在於 我們無法使用現有基於 DNA 的技術 來可靠地檢測它 由於微 RNAs 是非常短的核酸序列 遠遠小於 DNA 並且,所有的微 RNAs 之間非常相似 差別極其微小 就像試著去分辨出 兩個極其類似、極其微小的分子
We believe that we have found a way to do so, and this is the first time that we've shown it in public. Let me do a demonstration. Imagine that next time you go to your doctor and do your next standard blood test, a lab technician extracts a total RNA, which is quite simple today, and puts it in a standard 96-well plate like this one. Each well of these plates has specific biochemistry that we assign, that is looking for a specific microRNA, acting like a trap that closes only when the microRNA is present in the sample, and when it does, it will shine with green color. To run the reaction, you put the plate inside a device like this one, and then you can put your smartphone on top of it. If we can have a camera here so you can see my screen. A smartphone is a connected computer and it's also a camera, good enough for our purpose. The smartphone is taking pictures, and when the reaction is over, it will send the pictures to our online database for processing and interpretation. This entire process lasts around 60 minutes, but when the process is over, wells that shine are matched with the specific microRNAs and analyzed in terms of how much and how fast they shine. And then, when this entire process is over, this is what happens. This chart is showing the specific microRNAs present in this sample and how they reacted over time. Then, if we take this specific pattern of microRNA of this person's samples and compare it with existing scientific documentation that correlates microRNA patterns with a specific presence of a disease, this is how pancreatic cancer looks like. This inside is a real sample where we just detected pancreatic cancer.
我們認為已經發現一個分辨的辦法 這是我們首次公佈於眾 我來示範一下 想像你下次去看醫生 要做一次血常規檢測 一名實驗技術員提取了一條完整 RNA 這在當今是很簡單的 然後放入一個這樣的標準 96 孔盤中 這些標準試劑盤中,每一個孔中 都有我們預先分配好的特定生化試劑 以對應找出特定微 RNAs 這看來像一個設置好的陷阱 只有當血液樣本中的微 RNAs 被檢測到 它開始閃現綠光 為完成這一反應 你要把試劑盤放入這樣一個設備當中 接下來把智慧型手機放在它上方 請把攝影機對準這裡 讓大家可以看到我的手機螢幕 手機和電腦連接在一起 手機同時也是攝影機 足夠實現我們的目標 手機在照相 當反應結束後 手機把圖片 發送到我們的 線上數據庫中進行處理 和解讀 全過程大約持續 60 分鐘 當程序結束後 閃光的試劑孔與特定微 RNAs 配對分析 根據閃光的亮度和頻率得出分析結果 當全部過程完成後 這是我們得到的結果 這張圖顯示了血液樣本中 所含的特定微 RNAs 和它們隨著時間的變化反應 接下來,我們將這一樣本中的 微 RNAs 的特定類型 總結出來 與現有的科學文獻進行比較 由於這些文獻已將特定的微 RNAs 類型 與特定的疾病表現進行了關聯 我們檢測出樣本結果為胰腺癌 剛檢測出來的胰腺癌樣本 是一個真實的案例 (掌聲)
(Applause)
Another important aspect of this approach is the gathering and mining of data in the cloud, so we can get results in real time and analyze them with our contextual information. If we want to better understand and decode diseases like cancer, we need to stop treating them as acute, isolated episodes, and consider and measure everything that affects our health on a permanent basis. This entire platform is a working prototype. It uses state-of-the-art molecular biology, a low-cost, 3D-printed device, and data science to try to tackle one of humanity's toughest challenges. Since we believe early cancer detection should really be democratized, this entire solution costs at least 50 times less than current available methods, and we know that the community can help us accelerate this even more, so we're making the design of the device open-source.
我們方法的另一重要部分是 在雲端進行數據的收集和整理 這使我們能即時得到檢測結果 並與相關訊息結合分析 如果我們希望更加了解 和揭秘類似癌症這樣的疾病 我們應該停止那種 治療突發、孤立疾病的治療方式 開始分析和評估所有因素 所有會影響我們長期健康的因素 這一檢測系統還是一個原型機 它應用了最先進的分子生物科技 通過低成本的 3D 列印技術製作 及數據庫技術 來嘗試解決一個人類最艱難的挑戰 我們相信,癌症早期檢測方法 應該被推廣普及化 我們的整套檢測方案相對目前的檢測方法 費用節省至少 50 倍 我們也知道 相關行業的關注能幫助我們 更迅速完善推廣這一方案 現在我們將設備的設計方案 免費公開
(Applause)
(掌聲)
Let me say very clearly that we are at the very early stages, but so far, we have been able to successfully identify the microRNA pattern of pancreatic cancer, lung cancer, breast cancer and hepatic cancer. And currently, we're doing a clinical trial in collaboration with the German Cancer Research Center with 200 women for breast cancer.
你們要知道 我們目前仍處於起步階段 但我們已經可以 成功分辨出了 一些癌症的微 RNAs 類型 如胰腺癌、肺癌 乳腺癌、肝癌 目前,我們正在進行一項臨床試驗 實驗是與德國癌症研究中心合作 有 200 位女性參與的乳癌臨床試驗
(Applause) This is the single non-invasive, accurate and affordable test that has the potential to dramatically change how cancer procedures and diagnostics have been done. Since we're looking for the microRNA patterns in your blood at any given time, you don't need to know which cancer you're looking for. You don't need to have any symptoms. You only need one milliliter of blood and a relatively simple array of tools.
(掌聲) 這是一個單項的、無創傷 準確和可負擔的檢測方案 可能會徹底改變 以往癌症的診斷程序和診斷方法 因為我們檢測的是任意時間下 血液內的微 RNAs 類型 所以你不必知道 所要檢測的特定癌症類型 你也不用等到感覺到有任何症狀 只需要一毫升血液樣本 和一系列相對很簡單的工具
Today, cancer detection happens mainly when symptoms appear. That is, at stage 3 or 4, and I believe that is too late. It is too expensive for our families. It is too expensive for humanity. We cannot lose the war against cancer. It not only costs us billions of dollars, but it also costs us the people we love. Today, my aunt, she's fighting bravely and going through this process with a very positive attitude. However, I want fights like this to become very rare. I want to see the day when cancer is treated easily because it can be routinely diagnosed at the very early stages, and I'm certain that in the very near future, because of this and other breakthroughs that we are seeing every day in the life sciences, the way we see cancer will radically change. It will give us the chance of detecting it early, understanding it better, and finding a cure.
當前,癌症檢測通常發生於 患病症狀顯現後 這已經是癌症的第三或四階段 我認為這已經太遲了 對一個家庭來說代價太大了 對全人類來說代價也太大了 我們不能在與癌症的鬥爭中失敗 失敗的損失不僅是無數的金錢 還會失去我們所愛的人 如今,我的阿姨正勇敢抗爭著 她以積極樂觀的態度面對這一過程 可是,我還要努力把這樣的抗爭 變得越來越少出現 我希望有一天 癌症可以輕鬆治癒 因為,在常規體檢中 初期癌症就可以檢測到 我堅信 不久的將來 因為這套檢測系統 和其他生命科學領域 不斷出現的突破 我們看待癌症的方式 將會根本改變 對癌症,我們將有機會及早發現 深入了解 徹底治癒
Thank you very much.
感謝大家
(Applause)
(掌聲)