Alternatively, spatial–temporal reasons could also explain the lack of NANOG expression in OPMD that lately progressed to OSCC, as plausibly, OPMDs could have been biopsied before aberrant NANOG expression occurred, or cancer could develop from lesions not clinically visible at the time of biopsy and consequently unexamined. Here, NANOG is linked to oculopharyngeal muscular dystrophy.