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). Here, GHRL is linked to neoplasm.