Personalized and Precision Medicine Journal

Abstract Background
Cancer associated thrombotic microangiopathy (CA-TMA) is a rare diagnosis that while confronting a patient with evidence of microangiopathic hemolytic anemia and thrombocytopenia with normal ADAMTS13 enzyme activity, should be considered. Here we present two cases of cancer associated TMA; breast cancer and gastric cancer.
Case presentation
Case 1 was a 40-year-old man presented with abdominal pain, icterus and weight loss and laboratory tests revealed microangiopathic hemolytic anemia. He received 6 sessions of plasma exchange under diagnosis of thrombotic thrombocytopenic purpura. Bone marrow biopsy and immunohistochemistry revealed clusters of non-hematopoietic cells suggestive of gastrointestinal adenocarcinoma. Case 2 was a 51-year-old woman whose clinical history and laboratory tests were similar to case 1 except for a breast mass along with axillary lymphadenopathy. Bone marrow examination revealed clusters of non-hematopoietic cells and core needle biopsy revealed invasive lobular carcinoma.
Both patients were unresponsive to plasma exchange and case 1 unfortunately shortly died after diagnosis but case 2 is alive and survived after receiving chemotherapy. 
Conclusion
Cancer associated TMA can rarely be seen as the first manifestation of a malignancy and causes a diagnostic dilemma for clinicians.The prognosis of CA-TMA is generally poor and initiatingchemotherapy is the only reliable treatment option.

Abstract Gastric cancer is the fourth most common cancer worldwide and it ranks second among cancer deaths. Several studies have shown that FGL2 contributes to the pathogenesis of a number of infectious diseases, However, little is known about its biological functions in cancer development and metastasis. In this study, we investigated the correlation between FGL1 expression and prognosis in GC patients. gastric  cancer tissue  and adjacent healthy pecimens (n=20) were obtained from patients aged between 30 and 50 years who were diagnosed with in gastric cancer, Total RNA was extracted, Reverse transcription and qPCR was performed and Relative expression level was calculated using the 2-∆∆Cq  method. We found that the expression of FGL1 in gastric cancer tissues were obvi­ously higher than that in the adjacent tissues at mRNA levels (p <0.003).