Using Scanning Electron Microscopy and Atomic Force Microscopy to Study the Formation of Nanoparticles on Red Blood Cell Surface in Cervical Cancer Patients

Background: In this study, we used scanning electron microscopy (SEM) and atomic force microscopy (AFM) to examine the changes in morphology of red blood cells (RBCs) and to investigate the nanoparticles (NPs) found on their surface in cervical cancer (CC) patients undergoing radiation therapy (RT). Methods and Results: We obtained smears of venous blood from 12 CC patients at the start, midway and at the end of external beam RT and then midway and at the end of brachytherapy. It was found that in CC patients, the number of RBCs with abnormal morphology increased and NPs appeared on their surface. During RT, the total number of abnormally shaped RBCs and the number and size of NPs increased. The RBC diameter was 8.38 +/- 0.36 mu m in the control group and 9.41 +/- 0.47 mu m in CC patients. The average diameter of NPs on the RBC surface was 69.91 +/- 12.15 nm and their average height 23.75 +/- 3.70 nm. After RT, the morphology of RBCs was restored, and the formation of NPs decreased. Conclusion: The changes observed could serve as the basis for developing efficacy indicators of cancer radiation therapy.