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The DELPHI study is examining changes to the immune system that may predict the development of liver cancer.  DELPHI investigators will collect blood and urine samples as well as small samples of cells directly from the liver. In the case of liver cells, this will be done using a technique called liver fine needle aspiration. This technique is low risk and has been successfully used in other studies. The investigators will be recruiting 30 cancer patients (malignancy cohort) and 30 patients with other diseases of the liver who are at risk of developing cancer in the future (control cohort). Liver cells, blood, urine or bile samples from the different groups will be compared to identify changes specific to patients who have liver conditions that may indicate a risk of developing cancer in future. These changes could be in the types of white blood cells found within the liver, or, they may be in products secreted by liver or immune cells. In the latter case cells may release small pieces of their DNA into the blood or change the types of metabolic products that they produce.  

DELPHI will be recruiting from one site, Oxford University Hospital NHS Foundation Trust, and will run actively for 5 years. Participants will be asked to attend up to 5 study visits where blood, urine, bile and optionally liver tissue via Fine-needle aspiration (FNA) will be collected. Those individuals who chose to undergo the FNA procedure will be asked to complete a questionnaire and will further receive a follow-up phone call to record any adverse events to the procedure.