There has always been an intimate and complex relationship between the diagnosis of a disease and its treatment. The approach dubbed theranostics aims to combine diagnostic techniques with therapeutic ones by deploying the same molecule in two roles, exploiting the specificity of its function to render disease treatment more effective. Does this technical development have the potential to change our conception of disease diagnosis? With the treatment approach so intimately linked to the diagnostic tool, might it be possible to treat a disease without having first made an independent clinical or laboratory diagnosis? Here we discuss medical diagnosis, arguing for three categories of diagnosis, before presenting an example of a theranostic approach using radioactive prostate-specific membrane antigen ligands. This example allows us to envision a form of theranostic agent that would be able to diagnose a cancer, for example, and engage directly in its treatment, opening up the possibility of treating patients at risk of developing this cancer without any other clinical diagnostic steps. Would it be a problem if these approaches eventually became independent of any specialist clinical diagnostic supervision? If a theranostic technique is shown to work, following its own logic, do we still need an independent ‘traditional’ diagnosis prior to its use? We argue that such a diagnosis would no longer be necessary provided certain conditions are fulfilled.

疾病的诊断与其治疗之间一直存在着密切而复杂的关系。这种被称为治疗诊断学的方法旨在通过将同一分子部署在两个角色中，将诊断技术与治疗技术相结合，利用其功能的特异性使疾病治疗更有效。这项技术发展是否有可能改变我们对疾病诊断的概念？由于治疗方法与诊断工具密切相关，是否有可能在不首先进行独立的临床或实验室诊断的情况下治疗疾病？在介绍使用放射性前列腺特异性膜抗原配体的治疗诊断方法的示例之前，我们在这里讨论了医学诊断，争论了三类诊断。这个例子让我们能够设想一种形式的治疗诊断剂，它能够诊断癌症，例如，并直接参与其治疗，开辟了治疗有患这种癌症风险的患者的可能性，而无需任何其他临床诊断步骤。如果这些方法最终独立于任何专业的临床诊断监督，会不会有问题？如果一种治疗诊断技术被证明是有效的，按照其自身的逻辑，在使用之前我们还需要独立的“传统”诊断吗？我们认为，只要满足某些条件，就不再需要这样的诊断。开辟了治疗有患这种癌症风险的患者的可能性，而无需任何其他临床诊断步骤。如果这些方法最终独立于任何专业的临床诊断监督，会不会有问题？如果一种治疗诊断技术被证明是有效的，按照其自身的逻辑，在使用之前我们还需要独立的“传统”诊断吗？我们认为，只要满足某些条件，就不再需要这样的诊断。开辟了治疗有患这种癌症风险的患者的可能性，而无需任何其他临床诊断步骤。如果这些方法最终独立于任何专业的临床诊断监督，会不会有问题？如果一种治疗诊断技术被证明是有效的，按照其自身的逻辑，在使用之前我们还需要独立的“传统”诊断吗？我们认为，只要满足某些条件，就不再需要这样的诊断。在使用之前，我们还需要独立的“传统”诊断吗？我们认为，只要满足某些条件，就不再需要这样的诊断。在使用之前，我们还需要独立的“传统”诊断吗？我们认为，只要满足某些条件，就不再需要这样的诊断。