The browser you are using is not supported by this website. All versions of Internet Explorer are no longer supported, either by us or Microsoft (read more here:

Please use a modern browser to fully experience our website, such as the newest versions of Edge, Chrome, Firefox or Safari etc.

Nils Wierup

Nils Wierup

Senior lecturer

Nils Wierup

Expression of Cocaine- and Amphetamine-Regulated Transcript Is Associated with Worse Survival in Small Bowel Carcinoid Tumors


  • Kalle Landerholm
  • Liliya Shcherbina
  • Sture E. Falkmer
  • Johannes Jarhult
  • Nils Wierup

Summary, in English

Purpose: Cocaine-and amphetamine-regulated transcript (CART) peptide exerts several regulatory functions acting both as neurotransmitter and hormone. We recently showed that CART is expressed in various neuroendocrine tumors, including small bowel carcinoids. The main objective of the present study was to examine whether CART expression is associated with survival in patients with small bowel carcinoid. Secondary aims were to assess whether CART expression is associated with other tumor characteristics or clinical symptoms. Experimental Design: Specimens from 97 patients with small bowel carcinoids were examined for CART expression using immunohistochemistry. A CART score was introduced on the basis of the proportion of CART immunoreactive cells. On inclusion, specimens were examined by routine histopathologic methods and detailed clinical patient data were retrieved. The effect of CART on cell viability was assessed in vitro using two intestinal tumor cell lines. Results: Expression of CART (P = 0.011) and increasing CART score (P = 0.033) were associated with worse disease-specific survival. Adjusting for age, disease stage, and tumor grade in multivariable analysis, CART expression was still associated with worse survival [Low CART HR, 5.47; 95% confidence interval (CI), 0.71-42.46; and High CART HR, 9.44; 95% CI, 1.14-78.14]. CART expression was not associated with patient age, disease stage, tumor grade, or any presenting symptom. Supporting our clinical data, we found that CART promoted tumor cell viability in vitro in two different tumor cell lines. Conclusion: Expression of CART in small bowel carcinoid tumors is associated with worse survival. Clin Cancer Res; 18(13); 3668-76. (C)2012 AACR.


  • Neuroendocrine Cell Biology
  • EXODIAB: Excellence of Diabetes Research in Sweden

Publishing year







Clinical Cancer Research





Document type

Journal article


American Association for Cancer Research


  • Cancer and Oncology



Research group

  • Neuroendocrine Cell Biology


  • ISSN: 1078-0432