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  • Moles, birthmarks, beauty marks.

    痣,胎記,美人斑。

  • Most people have multiple moles, and they come in lots of different shapes and sizes.

    大多數人有多個痣,而且它們的形狀和大小都差很多。

  • Usually they're harmless, but occasionally they could be a sign of a very serious disease:

    通常它們是無害的,但有時它們可能是一種非常嚴重的疾病的跡象:

  • melanoma.

    黑色素瘤。

  • So, when is a mole just a mole, and how does it turn into a deadly form of cancer?

    那麼,什麼時候痣只是痣,它又如何變成致命的癌症呢?

  • Now, not all melanomas start from a mole, but all moles are made up of the type of cells

    並不是所有的黑素瘤都是從痣變成的,而是所有的痣,都是由可以變成黑素瘤的細胞

  • that can become melanomas: melanocytes.

    所組成的:黑素細胞。

  • Hi, my name is Aaron Mangold.

    嗨,我叫 Aaron Mangold。

  • I'm an assistant professor of dermatology at the Mayo Clinic in Arizona.

    我是亞利桑那州《梅約醫學中心》皮膚病學的助理教授。

  • I specialize in cancer genomics as well as utilizing advanced forms of genetics to prognosticate

    我專門研究癌症基因,並利用先進的遺傳學方法來預測

  • cancers for spread to other areas of the body, as well as for therapeutic interventions.

    癌症是否擴散到身體的其他部位,以及進行干預性治療。

  • Melanocytes primarily protect skin cells from ultraviolet damage through the production of pigment called melanin.

    黑色素細胞透過產生黑色素,來保護皮膚細胞免受紫外線傷害。

  • Melanocytes deliver melanin to the surrounding keratinocytes, or skin cells in the epidermis, giving our skin its color.

    黑色素細胞將黑色素傳遞到周圍的角質細胞,或表皮細胞,使我們的皮膚變色。

  • When we come in contact with ultraviolet light from the sun, this melanin protects our skin

    當我們接觸來自太陽的紫外線時,這種黑色素可以保護我們的皮膚免受傷害

  • from damage, while also signaling to the body to produce more melanin.

    同時還可以向身體發出信號,來製造更多的黑色素。

  • This is why you might tan when you go out in the sun.

    這就是為什麼你出去曬太陽時會曬黑的原因。

  • And this system works pretty well, but it's not perfect.

    這套機制運行良好,但並不完美。

  • So melanocytes really have evolved over time to be extremely resistant to ultraviolet light.

    黑色素細胞的確已經隨著時間的演進,進化成對紫外線具有極強的抵抗力。

  • They've become extremely resistant to acquiring mutations that in normal cells might lead

    它們已經變得對於正常細胞中,為防止突變而產程的自毀功能

  • to apoptosis, or cell death.

    產生了強大的抵抗力。

  • And they also are able to circulate innately throughout the body.

    而且它們還能夠在體內自然循環。

  • Since melanocytes aren't as likely to die due to DNA damage from UV light, they obtain

    由於黑素細胞不太可能因紫外線破壞 DNA 而死亡

  • mutations and can continue to grow and may cluster together, forming non-cancerous growths

    因此它們會發生突變,並且可以繼續生長並聚集在一起,形成非癌性生長

  • called "nevi," or moles.

    稱之為「痣」。

  • Those damaged melanocytes can then acquire additional mutations and continue to proliferate

    那些受損的黑素細胞可轉為其他的突變,並繼續增殖

  • forming a precancerous lesion or eventually a melanoma.

    形成癌前病變,或最終形成黑素瘤。

  • One mutation that almost all moles have is in the gene BRAF, a protein that is part of

    幾乎所有突變的痣都有一種 BRAF 基因 ,是細胞生長中有關於

  • cell signaling involved in cell growth.

    細胞信號傳遞地的一種蛋白。

  • But, a single BRAF mutation is not enough to cause cancer.

    但是,單個 BRAF 突變不足以引起癌症。

  • And not all melanomas even come from moles.

    而且並非所有黑色素瘤都來自痣。

  • So the way that melanoma, or the way that a melanocyte becomes a melanoma, occurs through a fairly long process.

    因此,黑色素瘤,或黑色素細胞變成黑色素瘤,是經過相當漫長的過程後才形成的。

  • There's not one specific change that happens that leads to it.

    並非是一個特定的變化導致它的發生。

  • It's a series of changes.

    而是一連串的變化。

  • Additional mutations in genes can be caused by things like further damage due to UV light.

    基因中的其他突變,可能是由於像是紫外線等造成的損壞所致。

  • These changes prevent natural cell death and lead to uncontrolled growth of the cancerous melanoma cells.

    這些變化防止了細胞死亡,卻也導致黑色素瘤的癌細胞不受控制地生長。

  • Fortunately, melanomas can be removed if discovered early enough.

    幸運的是,如果發現的夠早,可以將黑色素瘤切除。

  • And there are ways to check if a mole is irregular, which we'll talk about a little later.

    還有一些方法可以檢查痣是否異常,我們稍後再討論。

  • But, what happens if melanoma isn't caught?

    但是,如果沒有發現黑色素瘤怎麼辦?

  • ...the melanoma cells, they're able to acquire certain properties that make them not want

    ... 黑色素瘤細胞能夠獲得某些特性,從而使其不再願意

  • to stay in the skin any more.

    待在皮膚中。

  • And once they acquire those, they can actually go into things called lymphatics in the bloodstream and then can spread.

    一旦獲得了這些特性,它們實際上就可以進入血液中的淋巴組織,然後傳播開來。

  • Once melanoma has reached this stage and has spread from the lymph nodes to other parts

    黑色素瘤一旦達到這一階段,並從淋巴結擴散到身體的其他部位

  • of the body, it's very hard to cure.

    就很難治愈。

  • It also has a high mortality rate, only 23% of patients survive past five years.

    它也有很高的死亡率,在過去五年中只有 23% 的患者存活。

  • So it's important to identify an abnormal mole soon so that it can be removed.

    因此,儘早發現異常的痣是很重要的,以便及時將其除去。

  • Fortunately, there is an easy ABCDE rule to follow, which checks for asymmetry, irregular

    幸運的是,有一個容易遵循的 ABCDE 法則,該規則檢查痣是否不對稱,邊緣是否不規則

  • borders, uneven color, increasing diameter and an evolution or change in the mole.

    顏色是否不均勻,直徑是否增大,以及痣是否持續發展或變化。

  • An individual might say that this lesion is just different.

    某個人可能會說,這這顆痣長得很不一樣。

  • This doesn't look like everything else on me.

    這不像我身上長的其他東西。

  • That ugly duckling sign I think is also very useful in having some form of self body awareness

    我認為這個醜的小鴨標誌,某種程度上對自我身體察覺也非常有用

  • and say, "I want this looked at."

    而會說:「我希望檢查一下這顆痣。」

  • Specialists like Dr. Mangold are also starting to use immunotherapy to combat later stage

    像 Mangold 博士這樣的專家,也開始使用免疫療法來對抗後期的黑色素瘤

  • melanoma, using the body's natural defenses to fight the disease.

    利用人體的自然防禦力來抵抗這種疾病。

  • Normally our immune system will travel throughout the body, the immune cells will, and those

    通常,我們的免疫系統遍及整個身體,免疫細胞會巡遍全身

  • immune cells will look at individual normal cells and say, "How abnormal are you?”

    這些免疫細胞會盯著個別的個正常細胞,然後說:「你的異常達到何種程度?」

  • ...And when they have those signals telling them that they've acquired too much damage,

    …… 當免疫細胞接受到細胞受損太嚴重的信號時

  • the immune system then kills them….

    免疫系統就會殺死它們 ……

  • Well, cancer cells have figured out how to use certain proteins like that that will say,

    癌細胞已經弄清楚如何使用某些蛋白質,釋放出這樣的訊息

  • "Don't worry about it.

    「不要 擔心。

  • Everything is okay.

    沒事。

  • We're doing fine.

    我們很好。

  • Leave us alone."

    不用管我們。」

  • Recently, they figured out how to block those, how to block those signals that quiet the immune system.

    最近,專家們發現如何阻止這些信號,如何阻止那些使免疫系統失效的信號。

  • And it's really revolutionized not just the care of cancer as it pertains to melanoma,

    它不僅對黑素瘤的癌症治療,而且對所有癌症治療

  • but cancer in general.

    都是一項重大的突破。

  • But immunotherapy is still an emerging science.

    但是免疫療法仍是一門新興科學。

  • Doctors have to avoid making the immune system too active.

    醫生必須避免使免疫系統過於活躍。

  • This would result in an autoimmune disease, or an immune system that attacks healthy cells.

    這將導致自身免疫疾病,或免疫系統去攻擊健康細胞。

  • It's really analogous to playing a musical instrument or playing a piano.

    這很像是演奏樂器或彈鋼琴。

  • You have all the keys that are there.

    有的音符都已經在那兒了。

  • Yet, you can make good music, or you can make bad music.

    你可以奏出好聽的音樂,你也可以奏出難聽的音樂。

  • And we're trying to figure out now, how do we make good music and how do we avoid that kind of bad music?

    而且我們現在正努力弄清楚,我們如何奏出好聽的音樂,如何避免奏出難聽的音樂?

  • While immunotherapy is still developing, there is one treatment that everyone can take part in.

    儘管免疫療法仍在發展,但有一種治療方法每個人都可以參與。

  • You don't want people to lose sight of what's important, and I think it was Bert Vogelstein

    你不希望人們忽略了重要的事情,我想是 Bert Vogelstein 這麼說的

  • who said this, that if you could give someone a pill and tell them, "This pill that I give

    那就是,如果你可以給某人一種藥,並 告訴他們:「我給你的這種藥

  • you is going to reduce your risk of cancer by 50%,"

    將使你罹癌的風險降低 50%」

  • that it would be across every news organization, every magazine cover.

    這將會登上所有媒體、雜誌的封面。

  • Someone would get a Nobel Prize for it.

    有人將因此而獲得諾貝爾獎。

  • And we do have that pill.

    我們確實有這種藥。

  • That pill is primary prevention through healthy behaviors, healthy eating, different things

    這種藥就是透過健康的行為,健康的飲食來做預防,每個人都管好自己

  • that we can do as individuals that will reduce those risks.

    就可以降低這些罹癌風險。

Moles, birthmarks, beauty marks.

痣,胎記,美人斑。

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B1 中級 中文 美國腔 細胞 黑色素 免疫 突變 癌症 紫外線

痣是怎麼變成癌的? (How Do Moles Become Cancerous?)

  • 67 7
    Jerry Liu 發佈於 2021 年 01 月 14 日
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