What Does the Indication of NBI Show CPIIIb Type Mean in a Colonoscopy Report?

Gastrointestinal diseases are complex, as they occur internally, making it difficult to accurately assess their condition solely based on symptoms. In such cases, colonoscopy becomes essential for examination. When colonoscopy results indicate CPIIIb type under Narrow Band Imaging (NBI), it signifies the presence of adenomatous polyps in the intestine, necessitating prompt treatment.

What Does CPIIIb Type Under NBI During Colonoscopy Mean?

NBI is a narrow-band imaging technology, and CPIIIb type refers to adenomatous polyps, also known as "polypoid adenomas." These are adenomas that form in the mucosa, often appearing as polyps, particularly in the gastrointestinal mucosa, more commonly in the colon. They can be solitary or multiple, with or without stalks. In familial adenomatous polyposis (FAP), the colon mucosa is covered with numerous polyps of varying sizes, sometimes numbering in the hundreds or thousands, affecting the entire colon and rectal mucosa, predisposing to malignancy. NBI, also known as endoscopic narrow-band imaging, is an emerging endoscopic technology that utilizes filters to remove the broadband spectrum from the red, blue, and green light waves emitted by the endoscopic light source, leaving only the narrow-band spectrum for diagnosing various digestive tract diseases.

The primary advantages of NBI endoscopy lie in its ability to precisely observe the morphology of the digestive tract mucosal epithelium, including epithelial glandular pits, as well as the pattern of the epithelial vascular network. This innovative technology enhances endoscopists' ability to differentiate gastrointestinal epithelia, such as intestinal metaplasia in Barrett's esophagus, vascular pattern changes in gastrointestinal inflammation, and irregular changes in glandular pits in early gastrointestinal tumors, thereby improving the accuracy of endoscopic diagnosis.

Treatment of Familial Adenomatous Polyposis

Familial adenomatous polyposis (FAP) is an autosomal dominant genetic disorder characterized by the widespread development of tens to hundreds of polyps of varying sizes in the large intestine. In severe cases, polyps can occur from the mouth to the rectal anal canal, numbering in the thousands. These polyps range in size from that of a soybean to several centimeters in diameter, often densely arranged, sometimes in strings or clusters. The primary surgical principle for FAP is to remove all potentially diseased large intestinal mucosa. Consequently, the following surgical approaches are primarily employed:

1. Total colectomy with end ileostomy: This involves removing the intestinal tissue from approximately 10cm proximal to the ileocecal valve to the dentate line, with the creation of an ileal stoma in the right lower abdomen. However, this surgery can significantly reduce patients' quality of life, leading to its limited adoption.
2. Total colectomy with ileorectal anastomosis: Similar to the above, but with reanastomosis of the ileum and rectum to restore intestinal continuity, preserving the anus and improving postoperative quality of life.
3. Total proctocolectomy with ileal pouch-anal anastomosis (IPAA): Increasingly popular in the last two decades, this procedure involves the same extent of resection, with the creation of an ileal pouch that is then anastomosed to the dentate line, addressing the issue of increased postoperative bowel movements.