MYCN and neuroblastoma: Nonetheless, previous studies have suggested that cases with MYCN gene amplification and diffuse and strong protein expression would correlate with a worse outcome when compared with cases with MYCN gene amplification but only focal positivity or negative MYCN IHC.9 Presently, only the MYCN gene status by FISH (not the protein expression level) is considered in the risk classification of patients with NB.