NCAN and Merkel cell skin cancer: However, when presence of MCPyV DNA and NCAN expression (low vs. intermediate and high) were investigated in a multivariable Cox proportional hazards analysis for MCC-specific survival, virus-negativity was associated with a significantly worse outcome (Hazard ratio [HR] = 2.29; 95% confidence interval [95% CI] = 1.22 to 4.33; p = 0.010), whereas low NCAN expression only showed a tendency for worse outcome (HR = 1.84; 95% CI = 0.91 to 3.70; p = 0.087).