However, the association between NELL-1 (+) and tumor remained controversial, Wang et al. reported no tumor was found among 15 NELL-1 (+) NM patients (14) while Caza et al. found that about one third of NELL-1(+) patients had a high prevalence of malignant tumors (30/91) (18). This evidence concerns the gene NELL1 and nemaline myopathy.