Abstract: Objective To investigate the expression of phosphatidylinositol 3 kinase (PI3K), phosphatase deleted on chromosome 10 (PTEN) and glycogen synthase kinase (GSK)-3β in astrocytoma and its relationship with clinicopathological features and prognosis. Methods Eighty astrocytoma tissue samples and 20 normal brain tissue samples were collected from January 2014 to December 2018,PI3K, PTEN and GSK-3βexpression in the above tissues were detected by immunohistochemistry and real-time fluorescence quantitative PCR (qPCR). The relationship between their expression and clinicopathological features and overall survival(OS) was analyzed. Spearman method was used for correlation analysis, and Cox proportional hazards regression model was used for multivariate analysis. Results Immunohistochemical staining showed that the expression of PI3K increased with the increase of astrocytoma WHO grade (P=0.109), the expression of GSK-3βand PTEN decreased with the increase of WHO grade (P=0.029, P=0.033). qPCR showed that the relative expression of PI3K mRNA increased with the increase of astrocytoma WHO grade (P=0.158), and the relative expression of PTEN mRNA and GSK-3β mRNA decreased with the increase of astrocytoma WHO grade（P=0.038,P=0.029）. PI3K was negatively correlated with PTEN and GSK-3β(r=-0.263, P=0.018; r=-0.285, P=0.010); GSK-3β was not related to the expression of PTEN (r=0.056, P=0.620). The expression of PI3K was not related to clinicopathological parameters (P>0.05); The expression of PTEN and GSK-3β was related to WHO grade and IDH-1 expression (P<0.05), but not to age, sex and the expression of GFAP and Vimentin (P>0.05). The 1-year and 2-year survival rates of PI3K positive expression group were 57.1% and 31.0%, respectively, lower than 79.0% and 71.1% of negative expression group (P=0.001); The 1-year and 2-year survival rates in GSK-3β positive expression group were 74.4% and 61.5% respectively, which were higher than 61.0% and 39.0% in negative expression group (P=0.049); The 1-year and 2-year survival rates of PTEN positive expression group were 74.9% and 62.9% respectively, which were higher than 53.3% and 23.3% of negative expression group (P=0.270). Univariate analysis showed that WHO grade, and the expression of PI3K and GSK-3β were related to OS in patients with astrocytoma (P<0.05). Cox multivariate analysis showed that PI3K expression was the independent factor affecting OS in patients with astrocytoma (P=0.001). Conclusion  The level of PI3K increases with the increase of astrocytoma WHO grade, and the level of PTEN and GSK-3β decreases with the increase of WHO grade. The prognosis of patients with PI3K positive expression, and negative expression of PTEN and GSK-3β is poor. They may be involved in the occurrence and development of astrocytoma and have a certain value in predicting the prognosis.

Key words: Astrocytoma, Phosphatidylinositol 3 kinase, Phosphatase deleted on chromosome 10, Glycogen synthase kinase-3β