A statistically significant correlation between NCL and MYCN, MYC, and TERT was found in independent datasets (MultiPlatform786 ( n=786) and Agilent394 ( n=394). NCL expression significantly stratified also patients with >18 months and stage 4 tumour (OS: HR 1.8 95%CI 1.2–2.7, p=0.0009 EFS: HR 1.7 95%CI 1.1–2.5, p=0.002), patients with>18 months stage 4 with MYCN non amplified tumour), and patients with MYCN non amplified and MYC high EFS: HR 7.2 95%CI 1.6–33.4, p=0.01). In the MultiPlatform786 ( n=786), multivariate analysis suggested that NCL expression has a statistically significant prognostic value even in the model adjusted for established prognostic markers. In the stage 4 patients cohort qPCR20, patients with high NCLmRNA expression revealed a statisticallysignificant lower survival probability than those with low NCL expression (OS: HR 4.1 95%CI 1.2–13.8 p=0.0215, EFS: HR 4.1 95%CI 1.2–14.0, p=0.0197). NCL protein, down-modulated after chemotherapy in association with features of neuroblastic differentiation,resulted statistically significantly overexpressed in NB tumours and higher in stage 4 compared to stage 1,2,3 patients. The Lancet Regional Health – Western Pacific.The Lancet Regional Health – Southeast Asia. The Lancet Gastroenterology & Hepatology.
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