MYCN and neuroblastoma: While INGRSS is a preoperative risk stratification system for NB patients based on age at diagnosis, histological type, tumor grade, MYCN amplification status, 11q aberration, and DNA ploidy, and NB patients are divided into 4 risk groups accordingly: high risk, intermediate risk, low risk, and very low risk.[10] In addition, the children oncology group (COG) system is often used as a reference in making clinical treatment decisions.