Small renal masses, such as non-clear cell renal carcinoma (non-ccRCC), can be monitored rather than resected as morbidity is unlikely. The distinction between malignant clear cell RCC (ccRCC) from indolent RCC subtypes and benign renal tumour is not possible by imaging thus some patients undergo unnecessary surgery1. Using 2D COrrelated SpectroscopY we report that normal renal tissue, non-ccRCC and ccRCC each has different chemical profile. ccRCC differs from normal tissue with cholesterol and lipid increased by 572% and 481% (P=0.001); decreased alanine 51% (P=0.001); valine 57% (P=0.003) and lysine 46% (P=0.005). When comparing ccRCC to the non-ccRCC there are increases in valine 48% (P=0.004) and lysine 40% (P=0.04).
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