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痣与黑色素瘤 – 译学馆
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痣与黑色素瘤

How Do Moles Become Cancerous?

Moles, birthmarks, beauty marks.
痣 胎记 美人痣
Most people have multiple moles,
大部分人有很多痣
and they come in lots of different shapes and sizes.
它们形态各异 大小有别
Usually they’re harmless,
痣常为良性
but occasionall they could be
但有时会成为
a sign of a very serious disease: melanoma.
一种高度恶性疾病 即黑色素瘤的表现
So, when is a mole just a mole,
那么 什么时候痣只是一颗痣
and how does it turn into a deadly form of cancer?
又是怎么成为了恶性肿瘤呢?
Now,not all melanomas start from a mole,
黑色素瘤并非都由痣演变而来
but all moles are made up of the type of cells
但痣均由同一种细胞
that can become melanomas: melanocytes.
即可以形成黑色素瘤的黑素细胞构成
Hi,my name is Aaron Mangold.
你好 我是Aaron Mangold
I’m an assistant professor of dermatology
是亚利桑那州梅奥诊所的
at the Mayo Clinic in Arizona.
一名皮肤科助理教授
I specialize in cancer genomics as well as
专攻癌症基因组学
utilizing advanced forms of genetics to prognosticate
和利用先进的遗传学方法来预测
cancers for spread to other areas of the body,
癌症将要转移至身体何处
as well as for therapeutic interventions.
以及治疗干预
Melanocytes primarily protect skin cells from ultraviolet damage
黑素细胞主要通过一种叫黑色素的色素
through the production of pigment called melanin.
保护皮肤免受紫外线伤害
Melanocytes deliver melanin to the surrounding keratinocytes,
黑素细胞将黑色素 送至周围角质细胞
or skin cells in the epidermis,
或表皮的皮肤细胞
giving our skin its color.
使我们的皮肤呈现出颜色
When we come in contact with ultraviolet light from the sun,
当我们接触到来自太阳的紫外线
this melanin protects our skin from damage,
黑色素可保护我们皮肤免受伤害
while also signaling to the body to produce more melanin.
并促使机体产生更多黑色素
This is why you might tan when you go out in the sun.
这就是你在阳光下会晒黑的原因
And this system works pretty well, but it’s not perfect.
这层屏障非常有效 但并不完美
So melanocytes really have evolved over time
慢慢地 黑素细胞已进化得
to be extremely resistant to ultraviolet light.
对紫外线具有极强抵抗力
They’ve become extremely resistant to acquiring mutations
它们变得极难发生获得性突变
that in normal cells might lead to apoptosis, or cell death.
在正常细胞 获得性突变可引起凋亡或坏死
And they also are able to circulate innately throughout the body.
黑色素还可以在体内合成分解
Since melanocytes aren’t as likely to die due to DNA damage from UV light,
由于黑素细胞不太会死于紫外线导致的DNA损伤
they obtain mutations and can continue to grow and may cluster together,
故而它们发生突变 继续生长甚至成簇生长
forming non-cancerous growths called”nevi,” or moles.
形成非癌性增生 称为“胎记”或痣
Those damaged melanocytes can then acquire
那些受损的黑素细胞将获得
additional mutations and continue to proliferate
其他突变并增殖
forming a precancerous lesion or eventually a melanoma.
形成癌前病变 甚至黑色素瘤
One mutation that almost all moles have is in the gene BRAF,
几乎所有的痣都有BRAF基因突变
a protein that is part of cell signaling involved in cell growth.
该基因编码的蛋白是细胞信号通路的一部分 影响细胞生长
But a single BRAF mutation is not enough to cause cancer.
但是单纯BRAF突变不足以致癌
And not all melanomas even come from moles.
且并非所有黑色素瘤均来源于痣
So the way that melanoma,
所以黑色素瘤的形成
or the way that a melanocyte becomes a melanoma,
或者说一个黑素细胞形成黑色素瘤的过程
occurs through a fairly long process.
是一个漫长的过程
There’s not one specific change that happens that leads to it.
并没有导致黑色素瘤的特定改变
It’s a series of changes.
这是一系列的变化所致
Additional mutations in genes can be caused by things
基因中的其它突变可被某些因素触发
like further damage due to UV light.
如紫外线造成的进一步损伤
These changes prevent natural cell death
这些突变阻断了细胞自然死亡
and lead to uncontrolled growth of the cancerous melanoma cells.
并导致恶性黑素瘤细胞不受控制的生长
Fortunately, melanomas can be removed if discovered early enough.
幸运的是 如果发现得够早 黑色素瘤可以被移除
And there are ways to check if a mole is irregular,
有方法可检测痣是否异常
which we’ll talk about a little later.
我们稍后会讲到
But what happens if melanoma isn’t caught? …
但若黑色素瘤没被发现会怎样呢
the melanoma cells,
黑色素瘤细胞
they’re able to acquire certain properties
它们能获得某些特性
that make them not want to stay in the skin any more.
使它们不想再留在皮肤里
And once they acquire those,
一旦获得这些特性
they can actually go into things called lymphatics in the bloodstream
黑色素瘤细胞便会进入血液中的淋巴管
and then can spread.
从而转移扩散
Once melanoma has reached this stage
一旦黑色素瘤达到此期
and has spread from the lymph nodes to other parts of the body,
并从淋巴结扩散到身体其它部位
it’s very hard to cure.
就很难治愈了
It also has a high mortality rate,
此期死亡率极高
only 23 % of patients survive past five years.
五年生存率仅23%
So it’s important to identify an abnormal mole soon
所以尽早发现异常痣很重要
so that it can be removed.
这样才能将其移除
Fortunatly, there is an easy ABCDE rule to follow,
幸运的是 简单的ABCDE法可判断异常痣
which checks for asymmetry, irregular borders, uneven color,
此法即是检查痣对称性(A) 边缘规则性(B) 颜色均匀性(C)
increasing diameter and an evolution or change in the mole.
直径是否增大(D) 痣性状是否变化(E)
An individual might say that this lesion is just different.
有人可能会说这皮损只是不一样而已
This doesn’t look like everything else on me.
看起来和身上其他地方不同罢了
That ugly duckling sign I think is also very useful
我却认为这丑丑的标志很有用
in having some form of self body awareness
这是机体自我意识的表现形式
and say,”I want this looked at.”
它提示你“我得看看这儿”
Specialists like Dr. Mangold
一些专家 如Mangold博士
are also starting to use immunotherapy to combat later stage melanoma,
也开始使用免疫疗法来治疗晚期黑色素瘤
using the body’s natural defenses to fight the disease.
利用人体的自然防御来对抗疾病
Normally our immune system will travel throughout the body,
正常情况下 我们的免疫系统会在全身游走
the immune cells will,
免疫细胞将
and those immune cells will look at individual normal cells and say,
免疫细胞会检查机体正常细胞并盘问
“How abnormal are you?” …
“你哪里异常?”
And when they have those signals telling them that
当它们接收到那些
they’ve acquired too much damage,
细胞受到过多损伤的信号
the immune system then kills them…. ,
免疫系统就会杀死细胞
Well, cancer cells have figured out
然而 癌细胞已经找到
how to use certain proteins like that that will say,
利用特定蛋白来应对盘查的方法 它们骗免疫细胞
“Don’t worry about it.
“别担心
Everything is okay.
一切安好
We’re doing fine.
我们没事儿
Leave us alone.”
别管我们啦”
Recently they figured out how to block those,
近来它们发现了如何阻断
how to block those signals that quiet the immune system.
如何阻断那些让免疫系统沉默的信号
And it’s really revolutionized not just the care of cancer as it pertains to melanoma,
它不仅彻底改变了对黑色素瘤的治疗
but cancer in general.
也改变了对癌症的治疗
But immunotherapy is still an emerging science.
但免疫疗法仍是一门新兴学科
Doctors have to avoid making the immune system too active.
医生得防止免疫系统过于活跃
This would result in an autoimmune disease,
否则会导致自身免疫性疾病
or an immune system that attacks healthy cells.
或者免疫系统攻击正常细胞
It’s really analogous to playing a musical instrument or playing a piano.
这就好比演奏乐器或弹钢琴
You have all the keys that are there.
你能弹奏所有的音符
Yet, you can make good music, or you can make bad music.
然而 你奏出的乐曲或优美 或糟糕
And we’re trying to figure out now,
我们正试图探明
how do we make good music
如何奏出好旋律
and how do we avoid that kind of bad music?
以及避免发出难听的声音
While immunotherapy is still developing,
免疫疗法仍在不断发展
there is one treatment that everyone can take part in.
当下有一种人人可参与的治疗手段
You don’t want people to lose sight of what’s important,
你不希望人们忽视那些重要的事情
and I think it was Bert Vogelstein who said this,
我想此为Bert Vogelstein所言之意
that if you could give someone a pill and tell them,
如果你给某人一片药片并告诉他们
” This pill that I give you
“我给你的这片药
is going to reduce your risk of cancer by 50%,”
可以使你降低50%患癌风险
that it would be across every news organization, every magazine cover.
这消息将会传遍所有新闻机构 占领每本杂志封面
Someone would get a Nobel Prize for it.
有人将因此获诺贝尔奖
And we do have that pill.
我们确有此药
That pill is primary prevention through healthy behaviors,
这药就是病因预防 即通过健康行为
healthy eating, different things
健康饮食等各种
that we can do as individuals that will reduce those risks.
我们寻常人力所能及的事 从而降低患癌风险

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视频概述

简述了痣到恶黑的演变。ABCDE法则了解即可,具体判断建议找医生。

听录译者

收集自网络

翻译译者

郑丹翎

审核员

审核员XY

视频来源

https://www.youtube.com/watch?v=SWyzFYpcEn0

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