Tumour Microenvironment Characterisation and Immunological Evasion Mechanisms in Cervical Cancer Among HIV-Positive and HIV-Negative Women in Lagos State, South West Nigeria

The tumour microenvironment in cervical cancer mediates immunological evasion through complex interactions between tumour cells, infiltrating immune cells, and the cytokine milieu, and HIV co-infection may fundamentally alter these interactions with consequences for disease progression and immunotherapy responsiveness. This research characterises the tumour microenvironment and immunological evasion mechanisms in invasive cervical cancer specimens from HIV-positive and HIV-negative women at Lagos University Teaching Hospital, Lagos State, South West Nigeria. A case-control design will collect formalin-fixed paraffin-embedded biopsy tissue from 50 HIV-positive and 50 HIV-negative cervical cancer patients matched for tumour stage. Multiplex immunohistochemistry using panels for CD4, CD8, FOXP3, PD-L1, CD68, and HLA-DR will quantify immune cell infiltration and spatial organisation. HPV genotyping by linear array and E6/E7 mRNA expression by RT-PCR will characterise oncoviral contributions. Tumour mutational burden estimation will be performed on extracted DNA by targeted sequencing. Cytokine profiling of tumour tissue lysates by multiplex bead assay will characterise the local immune milieu. Comparative analysis will elucidate HIV-induced TME alterations. Original contributions include the first multiplex immunophenotyping of cervical cancer TME in a Nigerian cohort, a novel framework for HIV-TME interaction modelling, and evidence informing PD-L1 immunotherapy candidacy in Nigerian patients. Findings will contribute to biomarker-driven cervical cancer treatment stratification in South West Nigeria. Keywords: tumour microenvironment, cervical cancer, HIV, PD-L1, immunological evasion