GHRL and malignant colon neoplasm: However, another study reported significantly higher total serum ghrelin levels in 95 patients with colon cancer vs those in 39 healthy controls matched for age, gender and BMI; serum ghrelin level was also positively correlated with tumor size and end-stage vs initial stage tumors, and inversely associated with tumor differentiation, but not correlated with patient survival, independent of Dukes stages (Nikolopoulos et al. 2014).