Integrated Genomic and Transcriptomic Analysis of Cervical Cancer in Nigerian Women: HPV Genotype Distribution, Somatic Mutation Landscape, and Immunological Evasion Mechanisms

Cervical cancer is the most common gynaecological malignancy in Nigeria, and its molecular architecture, including the distribution of oncogenic HPV genotypes, somatic mutation landscape, and immunological evasion mechanisms, has not been characterised in a nationally representative genomic study. This study conducts an integrated genomic and transcriptomic analysis of cervical cancer in Nigerian women across five geopolitical zones. Fresh-frozen tumour biopsies and paired non-tumour cervical tissue are collected from 250 newly diagnosed cervical cancer patients at 10 gynaecological oncology centres. HPV genotyping is performed by multiplex PCR with Luminex hybridisation. Whole-exome sequencing characterises somatic mutation profiles, including PIK3CA, TP53, KRAS, and STK11. Bulk RNA sequencing with deconvolution analysis characterises the tumour immune microenvironment, with emphasis on CD8 T-cell infiltration, PD-L1 expression, and myeloid cell suppressor populations. HPV integration sites are mapped using CRISPR-seq-based techniques. Multi-omic data integration uses MOFA2 in R. The Cancer Hallmarks Framework and HPV Oncogenesis Theory provide the theoretical basis. Original contributions include the first integrated multi-omic characterisation of cervical cancer in a Nigerian population, identifying HPV genotype diversity beyond HPV-16 and HPV-18, and novel therapeutic targets in the immunological evasion pathway. Findings will support evidence-based revision of Nigeria's HPV vaccination programme and inform immunotherapy clinical trial design. Keywords: cervical cancer, HPV genotype, whole-exome sequencing, tumour immunology, Nigeria.