Characteristic molecular signature of pericardial effusion identifies malignant cancer in pericardial disorder patients

Background: Pericardial effusion (PE) can develop in patients with virtually any condition that affects the pericardium, including acute pericarditis and a variety of systemic disorders. Thus, definite differentiation of malignant pericardial effusion and rapid diagnosis are known to have therapeutic and prognostic importance. Objective: The aim of this study was to identify novel molecular markers for the detection of cancer in patients with pericardial disorder. Results: We performed one-way ANOVA analysis of whole transcriptome scans of 18 PEs from the patients with pericardial disorder including cancer. It resulted in 4385 outlier genes. Hierarchical clustering analysis showed two distinct clusters [cancer patient’s PEs (G1 + G2) vs. non-cancer PEs (G3)] within the dendrogram. To identify cancer-specific molecular signature, Welch’s t test of G1 and G3 was performed and 1639 gene elements were suggested as stringent classifiers between cancer PE and non-cancer PE. Gene set enrichment analysis of PE signature suggested that CD24, SDC1, and ST14 were strong molecular markers for identifying cancer patients among patients with pericardial disorder. Conclusion: Our results suggest that etiology-specific molecular signatures can discriminate cancer patients within pericardial disorder patients. CD24, SDC1, and ST14 are strong molecular markers for such discrimination.