科学美国人-在未来肺炎检测可以很简单

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Lung Cancer Screen Could Be Easy Pee-sy

By W. Wayt Gibbs on April 15, 2020

Credit: Getty Images

In mice, a test for lung cancer involves nanoprobes that recognize tumors and send reporter molecules into the urine for simple analysis.

Imagine getting screened for early-stage lung cancer simply by taking a deep breath from an inhaler and then peeing into a cup.

Sangeeta Bhatia, a professor of health sciences and engineering at M.I.T., described how that might be possible in a TED talk she gave in 2016:

[CLIP: “What if you had a detector that was so small that it could circulate in your body, find the tumor all by itself and send a signal to the outside world? It sounds a little like science fiction. But actually, nanotechnology allows us to do just that.”]

Bhatia’s idea was to invent nontoxic nanoprobes that doctors could put inside your blood or lungs or gut to detect tiny tumors when they’re easier to treat—before they grow big enough to spread throughout the body and damage vital organs.

[CLIP: “I dream that one day, instead of going into an expensive screening facility to get a colonoscopy or a mammogram or a pap smear, that you could get a shot, wait an hour and do a urine test on a paper strip.”]

In 2017 Bhatia’s team reported a proof-of-concept experiment in Nature Biomedical Engineering that demonstrated nanoprobes like this working to detect early-stage ovarian cancer in mice.

And now the group has refined this technology further to create a screening test for lung cancer that is more sensitive than the CT scans used today. The team of Harvard and M.I.T. researchers described their work in the April 1 issue of Science Translational Medicine. [Jesse D. Kirkpatrick et al., Urinary detection of lung cancer in mice via noninvasive pulmonary proteaseprofiling]

Lung cancer accounts for nearly a quarter of all cancer deaths in the U.S. each year, in large part because most cases of lung cancer are not caught until after the disease has already spread to other sites.

Yet when lung cancer is caught and treated early, the majority of patients survive the disease for at least five years. But CT screening for lung cancer is not widely used around the world, because it’s expensive, and more than 90 percent of positive tests turn out to be benign growths, not cancer. So this kind of screening leads to a lot of unnecessary and invasive biopsies.

In Bhatia’s study, which was done on mice genetically engineered to develop lung tumors very similar to those seen in people, the nanoprobes were able to detect tumors about 50 times smaller than other screening methods. And it produced no false positives.

The nanoprobes are designed to release reporter molecules when they come near certain kinds of lung tumors. Once released, the reporters pass into the blood, get filtered out by the kidneys and then exit the body in the urine.

The group is now working to repackage the nanoprobes into a form that could be inhaled as a powder or through a nebulizer. If that succeeds, then the technology will have to proceed through several years of clinical trialsbefore it could be used to screen people for lung cancer.

[CLIP: “And I hope that what this mean is that is that one day we can detect tumors in patients sooner than 10 years after they’ve started growing ... and that this would lead to earlier treatments and that we could save more lives than we can today with early detection.”]

—W. Wayt Gibbs

---from Scientific American

重点词汇汇总:

Lung Cancer Screen Could Be Easy Pee-sy肺癌筛查很容易

Easy Pee-sy 很容易（像尿尿一样容易）此处为一语双关，呼应下文是通过尿检来筛查癌症的（这种写法很高级）

nanoprobes 纳米探针

probe /proʊb/n. 探针；调查 vi. 调查；探测

reporter molecules 信号分子

pee 撒尿，小便

detector 探测器；检测器；

science fiction 科幻小说

nanotechnology /ˌnænoʊtekˈnɑːlədʒi/n. 纳米技术

nontoxic /nɑn'tɑksɪk/adj. 无毒的

tiny tumors 微小的肿瘤

spread throughout the body 遍布全身

vital organs.要害器官

colonoscopy /,kolənə'skɑpi/n. 结肠镜检查

mammogram /ˈmæməɡræm/n. 乳房X线照片

pap smear 宫颈涂片检查

urine test尿检

paper strip纸带；条形纸；试纸

a proof-of-concept experiment 一个概念验证实验

ovarian cancer 卵巢癌 

/oʊˈveriən/adj. [解剖] 卵巢的；子房的

refined /rɪˈfaɪnd/adj. [冶] 精炼的；精确的；微妙的；有教养的

CT scans 断层扫描；CT扫描

noninvasive pulmonary protease 非侵入性肺蛋白酶 

pulmonary/ˈpʌlməneri/adj. 肺的；有肺的；肺状的

protease/ˈproʊtieɪz/n. [生化] 蛋白酶

a quarter of 四分之一的

spread to other sites.传播到其他部位。

CT screening CT筛查

benign growths良性增生

benign/bɪˈnaɪn/adj. 良性的；和蔼的

invasive biopsies.侵入性活检。

biopsy /ˈbaɪɑːpsi/n. 活组织检查；

mice genetically engineered转基因小鼠（基因工程小鼠）

filtered out 筛选出来

nebulizer/'nɛbjə,laɪzɚ/n. 喷雾器

proceed through several years of clinical trials 进行数年的临床试验

百度翻译：

肺癌筛查很容易

作者：W.Wayt Gibbs，日期：2020年4月15日

图片来源：盖蒂图片社

在老鼠身上，一项肺癌检测包括识别肿瘤并将报告分子送入尿液进行简单分析的纳米探针。

想象一下，只需从吸入器深吸一口气，然后对着杯子小便，就可以筛查出早期肺癌。

麻省理工学院（M.I.T.）健康科学与工程教授桑吉塔•巴蒂亚（Sangeeta Bhatia）在2016年的一次TED演讲中描述了这一点的可能性：

[剪辑：“如果你有一个很小的探测器，它可以在你体内循环，找到肿瘤本身，并向外界发送信号，会怎么样？听起来有点像科幻小说。但实际上，纳米技术让我们可以做到这一点

Bhatia的想法是发明一种无毒的纳米探针，医生可以把它放在你的血液、肺或肠道中，以便在小肿瘤变得足够大，可以扩散到全身并损伤重要器官之前，在它们更容易治疗的情况下检测它们。

[剪辑：“我梦想有一天，你可以打一次针，等一个小时，在纸条上做一次尿检，而不是去昂贵的检查机构做结肠镜检查、乳房X光检查或子宫颈抹片检查。”]

2017年，Bhatia的团队报告了一项在自然生物医学工程中的概念验证实验，证明这种纳米探针能够检测小鼠早期卵巢癌。

现在该组织进一步改进了这项技术，创造出一种比现在使用的CT扫描更敏感的肺癌筛查试验。哈佛大学和麻省理工学院的研究小组在4月1日出版的《科学转化医学》杂志上描述了他们的工作。[Jesse D.Kirkpatrick等人，通过无创性肺蛋白酶分析法检测小鼠的肺癌]

肺癌每年占美国所有癌症死亡人数的近四分之一，很大程度上是因为大多数肺癌病例在疾病已经扩散到其他地方之后才被发现。

然而，当肺癌被发现并得到早期治疗时，大多数患者至少能存活5年。但是肺癌的CT筛查在全世界范围内并没有广泛应用，因为它很昂贵，超过90%的阳性检测结果是良性生长，而不是癌症。所以这种筛查会导致很多不必要的侵入性活检。

在Bhatia的研究中，这种纳米探针能够检测到比其他筛查方法小50倍的肿瘤，该研究是在基因工程小鼠身上进行的，以发展出与人类非常相似的肺部肿瘤。它没有产生假阳性。

纳米探针的设计目的是在接近某些类型的肺癌时释放报告分子。一旦释放，记者进入血液，被肾脏过滤出来，然后在尿液中排出体外。

该小组目前正致力于将纳米探针重新包装成一种可以作为粉末或通过雾化器吸入的形式。如果成功的话，这项技术必须经过几年的临床试验，才能用于筛选肺癌患者。

[剪辑：“我希望这意味着有一天我们能在肿瘤开始生长后的10年内检测出患者的肿瘤。。。这将导致更早的治疗，我们可以挽救更多的生命，比我们今天在早期发现。”

-W、 韦特吉布斯